中国心血管病研究2023年10月第21卷第10期ChineseJournalofCardiovascularResearch，October2023，Vol.21，No.10综述【摘要】冠状动脉旁路移植术（coronaryarterybypassgrafting，CABG）是冠心病的标准治疗方法之一，尤其适用于严重左心室收缩功能不全（左心室射血分数<35%）、冠状动脉多支病变、严重左主干病变和/或合并糖尿病的患者。如何进一步提高桥血管的通畅率、预防主要不良心脑血管事件（majoradversecardiovascularandcerebrovascularevents，MACCE）等一直是CABG术后备受关注的问题。抗血小板治疗作为CABG术后极为关键的一种二级预防措施，对患者预后起到重要作用。目前有大量有关抗血小板治疗方面的研究，指南也给出了抗血小板治疗相关的推荐。然而，CABG术后是否需要抗凝治疗存在较大的争议，相关证据也有限。本文总结归纳了CABG术后抗凝药物应用对患者预后的影响及其研究进展，旨在为临床治疗提供一定的参考依据。【关键词】冠状动脉旁路移植术；抗凝药物；桥血管CurrentstatusofanticoagulantuseaftercoronaryarterybypassgraftingCHENLian-xin，TIEMUERNIYAZIXieraili，FENGWei.DepartmentofCardiovascularSurgery，FuwaiHospital，ChineseAcademyofMedicalSciences&PekingUnionMedicalCollege/NationalCenterforCardiovascularDiseases，Beijing100037，ChinaCorrespondingauthor：FENGWei，E-mail：fengwei@fuwai.com【Fundprogram】NationalHighLevelHospitalClinicalResearchFunding[2022-GSP-GG-30]【Abstract】Coronaryarterybypassgrafting(CABG)isoneofthestandardtreatmentsforpatientswithcoronaryheartdisease,particularlyforthosewithsevereleftventricularsystolicdysfunction(leftventricularejectionfraction<35%),multivesseldisease,significantleftmaintrunkdisease,and/ordiabetesmellitus.ImprovingthegraftpatencyandpreventingmajoradversecardiovascularandcerebrovasculareventshavebeenthemajorconcernsafterCABG.Regardingtheseissues,antiplatelettherapyafterCABGhasbeenextensivelystudied,whileclinicalguidelinesalsohavespecificrecommendation.However,controversiesexistonwhethertoadministeranticoagulantsafterCABG.ThisreviewsummarizestheadvancesintheusageofanticoagulantsafterCABGanditsimpactontheprognosisofpatients,inordertoprovidecertainreferencesforclinicalpractice.【Keywor...
