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Evolving paradigms in antithrombotic therapy for anticoagulated patients undergoing coronary stenting
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- Buccheri, Sergio (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi
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- Angiolillo, Dominick J (author)
- Division of Cardiology, University of Florida College of Medicine, Jacksonville, FL, USA
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- Capodanno, Davide (author)
- Division of Cardiology, C.A.S.T., P.O. ‘G. Rodolico,’ Azienda Ospedaliero-Universitaria ‘Policlinico-Vittorio Emanuele,’ P.O. Rodolico, Ed. 8, Via Santa Sofia 78, Catania, Sicilia, Italy
- (creator_code:org_t)
- 2019-12-08
- 2019
- English.
- In: Therapeutic advances in cardiovascular disease. - : Sage Publications. - 1753-9455 .- 1753-9447. ; 13
- Research review (peer-reviewed)
Abstract
Subject headings
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- A sizable proportion of coronary artery disease (CAD) patients undergoing percutaneous coronary intervention (PCI) with stent implantation have an indication for treatment with oral anticoagulant therapy (OAC). The coexistence of atrial fibrillation (AF) and the need for PCI expose patients to a higher risk of developing thrombotic complications, and a multitargeted antithrombotic treatment strategy, addressing both platelet- and coagulation-mediated triggering mechanisms of thrombosis, is necessary for ensuring full protection from ischemic hazards. The increased bleeding risk identified with triple antithrombotic therapy has driven the search for alternative treatment modalities and pharmacological combination strategies aimed at achieving an optimal balance between safety and efficacy in this complex clinical scenario. Over a short time period, the paradigms surrounding the management of patients undergoing PCI who require OAC have substantially evolved. In this review, we summarize and critically evaluate the results of recent randomized clinical trials investigating the pharmacological management of patients who, in addition to antiplatelet therapy, have an indication for OAC treatment before or at the time of a PCI procedure.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- Antithrombotic therapy
- Atrial fibrillation
- Bleeding
- Percutaneous coronary intervention
- Stent thrombosis
- Stroke
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