medicina56巻2号

2019年02月発行

特集 抗血栓療法のジレンマ—予防すべきは血栓か，出血か？ Editorial

抗血栓療法をめぐる現状

著者： 上妻謙¹

所属機関： ¹帝京大学医学部内科学講座循環器内科

ページ範囲：P.206 - P.211

Point
◎心筋梗塞や脳梗塞の発症早期は出血リスクも高いが，血栓症の発症リスクはそれに増して高いことが多い．しかし，一定期間が経過して安定すると血栓リスクが出血リスクを下回ってくるので，その際には抗血栓療法を弱めるなどの時期別対応が必要となる．
◎ステント留置後の2剤併用抗血小板療法の期間は6カ月を基本として，個々の患者に合わせて調整することが必要となる．
◎心房細動を合併した冠動脈疾患など，抗凝固療法と抗血小板療法の併用が必要となる症例では，出血リスクがきわめて高いことを考慮し，両者の併用を極力短期間とすべきである．

参考文献

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