After hearing Pan list the key points of knowledge, the other students nodded frequently.
Yue Wentong did not deny: "The patient is taking warfarin."
As a patient after PCI surgery, you need to take anticoagulants such as warfarin for a long time according to the doctor's advice to prevent thrombosis in the stent. Thrombosis in the stent is more fatal than restenosis in the stent. The acute myocardial infarction caused by the thrombosis segment can make the mortality rate reach 20 to 40 percent.
Anticoagulants alone are not enough, and doctors often prescribe aspirin as an antiplatelet therapy. Aspirin is the most widely used antiplatelet drug in clinical practice and is a thromboxane A2 (TXA2) inhibitor.
Laymen may find it strange. Isn't it enough to use anticoagulants alone? Why do we need to add antiplatelets? Aren't they all antithrombotic? There are three types of antithrombotic drugs. In addition to the two above, the other most direct type is called thrombolytic drugs. In fact, thrombolytic drugs were a common treatment option for rescuing patients with acute myocardial infarction in the early days when there were no drug-eluting stents and bare stents were not reimbursed by medical insurance. Thrombolytic drugs are just as expensive, but they are cheaper than stent surgery and bypass surgery. If you think about its technical essentials, you will know why it is cheap. No surgery is required, and the technical requirements for hospitals and doctors are low. It can be carried out in small and medium-sized hospitals, while the former must be carried out in large hospitals.
Ordinary people are so poor that they have no choice.
Doctors in large hospitals do not like thrombolytic drugs because the use of thrombolytic drugs must be timed, and it is best to use them within three hours of myocardial infarction, otherwise the effect will be greatly reduced or ineffective. Secondly, thrombolytic drugs are ineffective for stubborn blood clots, which means that even after thrombolysis, angiography must be performed and stents must be placed. Moreover, the drug affects the whole body, unlike surgery which is limited to a part of the body. The complications caused by thrombolytic therapy can be terrible. Many patients with underlying diseases must use it with caution, and it is even more contraindicated for the elderly with various systemic problems. Problematic elderly people also suffer from many myocardial infarctions.
Patients who have some money and are persuaded by doctors will immediately PK thrombolytic therapy and thrombolytic drugs. They will undergo surgery and use two other antithrombotic drugs in combination after surgery to achieve better results.
Although anticoagulants and antiplatelet drugs are both antithrombotic drugs and different from thrombolytic drugs, they seem to be similar, but they are actually two types of drugs with completely different mechanisms of action. Whether it is physiological hemostasis or abnormal thrombosis, it is actually the aggregation and coagulation of platelets. The protagonists of the former are platelets, which run together and adhere to the blood vessel wall to stop bleeding or form thrombi. The latter plays an important role as coagulation factor, which is activated from a quiet state by receiving the signal of blood vessel damage, causing fibrin to change from soluble to insoluble, and pulling blood cells into a fibrin network to become a blood clot.
...
...
According to this principle, the antiplatelet drugs developed are designed to drive away platelets and prevent them from releasing, aggregating and adhering. Anticoagulants prevent the activation and conversion of coagulation factors.
Xie Wanying knew from her rebirth that if patients after PCI were to truly fight thrombosis, warfarin and aspirin were not enough. What was needed was anticoagulants plus dual antiplatelet therapy, or DAPT.
Why is it not used at this stage? Because the other type of antiplatelet drug used in DAPT is not aspirin, a thromboxane A2 (TXA2) inhibitor.
Continue read on readnovelmtl.com
