治疗冠心病这6类药很重要

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各位朋友：

大家好，现在是“每天健康三分钟”时间，我是道简-心血管康复医生集团的医生卜颖颖，今天我来给大家讲讲：治疗冠心病这6类药很重要！

对于冠心病、心肌梗死这类病变来说，在急性发作的时候需要迅速通过溶栓或者介入治疗开通堵塞的血管，挽救生命，这是毋庸置疑的。但是更重要的是平时坚持药物治疗，因为无论是否有放支架，药物治疗都是基础，没有规范的药物治疗，其他的血管也很可能会逐渐狭窄，堵塞。那么冠心病最常用的药物是哪些呢？

1、阿司匹林：对于冠心病患者来说，如果没有禁忌症，都需要长期服用，主要作用是抗血小板凝聚，预防血栓形成。

2、他汀类药物：例如阿托伐他汀、瑞舒伐他汀等，可以控制低密度脂蛋白胆固醇（LDL-C）、胆固醇等血脂水平，能稳定斑块，预防斑块破裂血栓形成。

3、β受体阻滞剂：例如美托洛尔、比索洛尔等，可以减少心肌的耗氧量，减慢心率，控制血压，减少心绞痛发作，改善心功能，增加运动耐量。研究显示，心梗患者长期使用后死亡率下降24%，如果没有禁忌的话，建议可以使用。

4、普利类或者沙坦类：研究显示，这类药物可以使心血管死亡、心肌梗死、脑卒中的风险下降22%，可以保护心功能、抑制心室的重构，是合并心力衰竭患者治疗的基石。

5、硝酸酯类药物：例如硝酸甘油、消心痛等，属于内皮依赖性血管扩张剂，可以改善心肌供血，缓解心绞痛的症状，少数患者可能会出现头痛、面部潮红等不良反应。

6、氯吡格雷或替格瑞洛：如果阿司匹林不能耐受或有禁忌症，可以替代。如果有急性冠脉综合症，需要和阿司匹林联用，如果有植入药物支架，一般至少要联合服药一年，然后根据情况选择是单用阿司匹林，还是继续双联抗血小板治疗。

7、其他：当然根据不同的病情，我们还可以选用曲美他嗪、尼可地尔、伊伐布雷定等等药物。

具体需要用哪些药物，必须在医生指导下进行调整，切勿自行停药。

最后，祝大家生活愉快，身体健康！如果您想要了解更多的心血管科普小知识，请关注我们，咱们下期再见。

【英文版】

Six kinds of very important drugs for the treatment of coronary heart disease

Dear friends, nice to meet you!Now it is time for “health talk for three minutes every day”,My name is Bu Yingying, a doctor of Daojian Doctor Group of Cardiovascular Rehabilitation.Today, I'd like to tell you the six important drugs for the treatment of coronary heart disease!

For coronary heart disease, myocardial infarction and other diseases,it is no doubt that thrombolytic therapy or interventional therapy is needed to open up the blocked blood vessels and save lives. However, it is more important for patients to adhere to drug treatment at ordinary times, because no matter whether there is stent implantation, drug treatment is the basis. Without standardized drug treatment, other blood vessels are likely to gradually narrow and block. So what are the most commonly used drugs for coronary heart disease?

1. Aspirin.

For patients with coronary heart disease, if there is no contraindication, patients need to take aspirin for a long term, and the main role of aspirin is to prevent platelet aggregation and thrombosis.

2. Statins.

For example, atorvastatin and rosuvastatin can control the levels of low-density lipoprotein cholesterol (LDL-C) and cholesterol, stabilize plaque and prevent plaque rupture and thrombosis.

3. Beta blockers.

Beta blocker, such as metoprolol, bisoprolol, etc., can reduce myocardial oxygen consumption, slow heart rate, control blood pressure, reduce angina pectoris attack,improve cardiac function, and increase exercise tolerance. Studies have shown that the mortality rate of patients with myocardial infarction after long-term use could be reduced by 24%. If there is no contraindication, it can be used.

4. Puli or sartans.

Studies have shown that such drugs can reduce the risk of cardiovascular death, myocardial infarction and stroke by 22%, they can also protect heart function and inhibit ventricular remodeling,which is the cornerstone of treatment for patients with heart failure.

5. Nitrates.

For example, nitroglycerin and isosorbide dinitrate are endothelium-dependent vasodilators, which can improve myocardial blood supply and relieve the symptoms of angina pectoris. A few patients may suffer from adverse reactions such as headache and flushing on the face.

6. Clopidogrel or ticagrelor.

If aspirin is intolerable or contraindicated, it can be replaced. If the patient is diagnosed with acute coronary syndrome, aspirin plus clopidogrel or ticagrelor is required.If patients have received coronary stent implantation, they usually need at least one year of combined medication, and then choose whether to use aspirin alone or continue dual antiplatelet therapy according to the situation.

7. Other drugs.

Of course, according to different conditions, we can also choose trimetazidine, nicorandil, ivabradine and other drugs.The specific drugs that patients need to take must be adjusted under the guidance of doctors, and do not stop taking drugs by themselves.

Finally, I wish you all a happy life and good health!To learn more about cardiovascular disease, please pay attention to us. See you next time.