The treatment of coronary artery disease is comprehensive and mainly includes conservative medical drug treatment, coronary intervention (PCI procedure) and coronary artery bypass grafting (CABG). Among them, coronary intervention is one of the effective means to treat coronary artery disease. The emphasis of post-intervention treatment is on dual antiplatelet therapy, and the rest is basically the same as the principles of secondary prevention treatment for coronary artery disease (commonly known as ABCDE principles). For coronary artery disease, coronary intervention is like repairing a “big road”, but the maintenance of the “big road” and the smoothness of the “road” after intervention are still inseparable from medical drug therapy. Therefore, whether the post-PCI medication is reasonable is, to a certain extent, a crucial factor in determining the clinical success and long-term success of coronary interventions. Specifically, as medical staff in primary care units, the following issues need to be given sufficient attention. 1.Which drugs are needed after coronary intervention? 1.Double antiplatelet drugs (aspirin + clopidogrel). After coronary intervention, especially for patients with coronary stents, antiplatelet drugs should be taken for a long time to prevent thrombosis in the stent (this is extremely important!). Dual antiplatelet agents should be taken for at least 12 months as long as they are not contraindicated, and in many special cases such as those with a propensity for in-stent thrombosis, an appropriate extension of the combination may be considered. (Aspirin usually needs to be taken for a long time). Coronary stent implantation is currently dominated by drug-eluting stents. If a metal bare stent is implanted, Bolivar should be taken for at least 1 month. 2. Statin lipid-lowering drugs. Such as simvastatin, atorvastatin, pravastatin, etc. 3.Take anti-anginal drugs according to the need of the disease. Such as calcium antagonists, beta-blockers and nitrates. 4, drugs to control the risk factors of coronary heart disease, if accompanied by hypertension, diabetes, the corresponding antihypertensive drugs, hypoglycemic drugs are needed. 2.How to apply anti-platelet drugs? After coronary intervention, especially after stent placement, patients should take oral antiplatelet drugs to prevent intra-stent thrombosis, which can lead to adverse cardiac events such as angina pectoris, myocardial infarction, heart failure and even sudden cardiac death. 1.Aspirin 100-300 mg, this product should be taken with warm water after meals not on an empty stomach, 1 time/day, after 1 month, change to 100 mg, 1 time/day, long-term oral; 2.Clopidogrel 75 mg (Bolivar, Tyga), 1 time/day, oral for more than 1 year (drug-eluting stent) or at least 1 to 3 months (bare metal stent). Blood routine, platelet and liver and kidney function should be reviewed regularly while taking antithrombotic drugs to reduce or prevent the occurrence of adverse drug reactions. 3, In addition, in the following patients, their taking antiplatelet therapy needs to be individualized, such as the left main stem, chronic occlusion, complex lesions, acute coronary syndrome, multi-branch severe lesions need to appropriately increase the clopidogrel dosage from 75 mg daily to 150 mg, once/day for 1-2 weeks and then change to 75 mg, once/day; individual patients due to triple antiplatelet therapy, on the basis of aspirin + Bolivar On top of triple antiplatelet therapy, add cilostazol (PEDA) 50-100 mg, 2 times/day, orally for 6-12 months. 4, people with a history of hemorrhagic gastric lesions, those with recent active peptic ulcer bleeding, aspirin is prohibited after PCI, and clopidogrel alone at a maintenance dose of 75 mg/day or in combination with PEDA 50-100 mg, 2 times/day, as needed, along with the application of gastric mucosal protective agents. 5. Patients taking dual antiplatelet drugs (aspirin + clopidogrel) should pay attention to whether they have bleeding tendency, such as bleeding gums, bleeding spots on the skin, and the presence of black stools, etc. Blood routine should be checked regularly. Long-term use of aspirin may cause peptic ulcers or bleeding. If you have stomach pain or black stools, you should go to the gastroenterology or emergency department promptly. Although antiplatelet drugs have side effects, in most cases they do not constitute serious consequences, so patients should not stop using antiplatelet drugs without authorization. If you encounter a situation that requires discontinuation (such as the need for surgical procedures), you should first consult with your surgeon or cardiology interventionalist before making a decision. 3.Do patients with normal lipids have to stop taking lipid-lowering drugs after PCI? Statins (simvastatin, atorvastatin, pravastatin, etc.) are generally required after coronary intervention. Normal postoperative lipids are not the same as meeting lipid standards. Statins for patients with coronary artery disease are not for lipid lowering, but for lipid regulation, plaque stabilization and slowing down the progression of atherosclerosis. At present, in many patients, after stopping statins, lipids may rebound, and the current view is that statin treatment is also a long-term process. However, according to the specific situation, after the lipid standard is reached and stabilized, the dosage can be reduced. 4.Is it necessary to use nitrate drugs after coronary intervention? What is the course of application? 1.For patients who have undergone PCI after infarction and achieved complete revascularization and no myocardial ischemia, if there is no other indication for nitrate application (such as severe heart failure or hypertension), nitrate drugs can no longer be used; 2.For patients who have undergone PCI but have not achieved complete revascularization (such as residual stenosis in the distal part of the offender vessel or untreated lesions in the non-offender vessel), nitrate drugs should still be used 3, after PCI for acute coronary syndrome, after complete hemodynamic reconstruction of the coronary artery has been achieved, nitrate drugs can be discontinued after 1-3 months of symptomatic improvement. 5.The treatment of Chinese medicine after intervention Coronary heart disease belongs to the category of chest paralysis and heart pain in Chinese medicine, and its pathogenesis lies in the blockage of heart vessels by blood stasis and phlegm, which causes pain if it does not pass. At present, most of the treatments are based on activating blood circulation and removing blood stasis, such as Danshen tablets, Danshen drops and Panax notoginseng. Modern medical research methods have found that many herbal medicines can significantly inhibit thrombosis and platelet aggregation and reduce blood viscosity. Lowering the concentration of lipid peroxide in the serum of patients with coronary heart disease and scavenging oxygen free radicals, they also have the effects of anti-ischemia, hypoxia, protection of myocardial cell function and inhibiting the development of atherosclerosis. However, there is a lack of evidence-based medical evidence on the appropriateness of herbal treatment after coronary intervention in the international arena. However, how to apply modern medical research methods to study the mechanism of action of traditional Chinese medicine has attracted great attention from scholars at home and abroad, and it is believed that traditional Chinese medicine has a promising future in the treatment of coronary heart disease. 6. Statin lipid-regulating drugs may damage the liver, can they be taken for a long time? Evidence-based medical evidence shows that statins can stabilize or even reverse the atheromatous plaque in coronary arteries. The incidence of liver function damage after taking statin lipid regulating drugs is very low (less than 1%), and the damage to the liver is mostly transient, mostly occurring within 1 to 2 months after taking the drug, and the mild elevation can be normalized by continuing the drug. Most of the patients with mild elevation of liver enzymes are safe to continue taking the drug for a long time. In addition, patients taking statins may have general weakness, muscle swelling or abnormal liver function, etc. Liver function and muscle enzymes should be rechecked 1-2 months after taking the drug or when the above symptoms appear. 7.If I have been taking antiarrhythmic drugs before the operation, should I continue to take them after the coronary intervention? If the arrhythmia is caused by coronary artery disease and myocardial ischemia, after coronary intervention and intervention of the “criminal” vessel (coronary artery that causes myocardial ischemia), the arrhythmia attack can be effectively reduced and the antiarrhythmic drugs can be reduced or even stopped. However, if you have a history of malignant arrhythmias before surgery, such as ventricular tachycardia and ventricular fibrillation, you should continue to take antiarrhythmic drugs after coronary intervention. 8.If you have been taking drugs for heart failure before surgery, will you continue to take them after coronary intervention? After coronary intervention, myocardial ischemia is improved and the symptoms of heart failure can be partially relieved. The amount of drugs for heart failure can sometimes be reduced under the guidance of doctors, but cannot be completely stopped. 9.Can I continue to take warfarin after coronary stenting in post-valve replacement patients? Patients can continue to take warfarin after valve replacement, but they should closely monitor PT and INR to maintain INR 1.8-2.5. No matter which type of patients need to stop or reduce the medication early, they should consult with relevant doctors by phone, do not just listen to non-cardiologists or non-interventional doctors or stop the medication by themselves to avoid adverse consequences. 10.Do I need to stop taking aspirin+Polyclovir if I have a tooth extraction or other minor surgical procedure after coronary stenting? Within 6 months after PCI, such surgery is not recommended, except for emergencies. If the condition requires surgery, stopping clopidogrel is not advocated. The specific situation should be managed in consultation with the interventional cardiologist as appropriate. In conclusion, the importance of drug therapy after coronary intervention cannot be overemphasized. Many patients have poor compliance and think that everything is fine after PCI and stop taking their drugs without permission, resulting in fatal cardiovascular events. We urge primary care physicians to understand the basic principles of general drug therapy during the peri-PCI period through daily outpatient visits, especially focusing on the necessity of dual antiplatelet therapy and the rational application of other drugs after PCI, which is crucial for the long-term prognosis of coronary heart disease PCI procedures. Finally, we emphasize that if you have an angina attack after PCI, you should go to a hospital with interventional treatment as soon as possible!