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Patient-tailored an...
Patient-tailored antithrombotic therapy following percutaneous coronary intervention
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- van der Sangen, Niels M. R. (author)
- Univ Amsterdam, Dept Cardiol, Amsterdam Cardiovasc Sci, Amsterdam UMC, Meibergdreef 9, NL-1105 AZ Amsterdam, Netherlands.
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- Rozemeijer, Rik (author)
- Univ Med Ctr Utrecht, Dept Cardiol, Heidelberglaan 100, NL-3584 CX Utrecht, Netherlands.
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- Yin, Dean R. P. P. Chan Pin (author)
- St Antonius Hosp, Dept Cardiol, Koekoekslaan 1, NL-3435 CM Nieuwegein, Netherlands.
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- Valgimigli, Marco (author)
- Cardioctr Ticino, Dept Cardiol, Via Tesserete 48, CH-6900 Lugano, Switzerland.;Bern Univ Hosp, Dept Cardiol, Freiburgstr 18, CH-3010 Bern, Switzerland.
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- Windecker, Stephan (author)
- Bern Univ Hosp, Dept Cardiol, Freiburgstr 18, CH-3010 Bern, Switzerland.
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- James, Stefan, 1964- (author)
- Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR)
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- Buccheri, Sergio (author)
- Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR)
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- ten Berg, Jurrien M. (author)
- St Antonius Hosp, Dept Cardiol, Koekoekslaan 1, NL-3435 CM Nieuwegein, Netherlands.;Univ Med Ctr Maastricht, Dept Cardiol, P Debyelaan 25, NL-6229 HX Maastricht, Netherlands.
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- Henriques, Jose P. S. (author)
- Univ Amsterdam, Dept Cardiol, Amsterdam Cardiovasc Sci, Amsterdam UMC, Meibergdreef 9, NL-1105 AZ Amsterdam, Netherlands.
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- Voskuil, Michiel (author)
- Univ Med Ctr Utrecht, Dept Cardiol, Heidelberglaan 100, NL-3584 CX Utrecht, Netherlands.
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- Kikkert, Wouter J. (author)
- Univ Amsterdam, Dept Cardiol, Amsterdam Cardiovasc Sci, Amsterdam UMC, Meibergdreef 9, NL-1105 AZ Amsterdam, Netherlands.;Onze Lieve Vrouw Hosp, Dept Cardiol, Oosterpk Str 9, NL-1091 AC Amsterdam, Netherlands.
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Univ Amsterdam, Dept Cardiol, Amsterdam Cardiovasc Sci, Amsterdam UMC, Meibergdreef 9, NL-1105 AZ Amsterdam, Netherlands Univ Med Ctr Utrecht, Dept Cardiol, Heidelberglaan 100, NL-3584 CX Utrecht, Netherlands. (creator_code:org_t)
- 2021-01-29
- 2021
- English.
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In: European Heart Journal. - : Oxford University Press. - 0195-668X .- 1522-9645. ; 42:10, s. 1038-
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Abstract
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- Dual antiplatelet therapy has long been the standard of care in preventing coronary and cerebrovascular thrombotic events in patients with chronic coronary syndrome and acute coronary syndrome undergoing percutaneous coronary intervention, but choosing the optimal treatment duration and composition has become a major challenge. Numerous studies have shown that certain patients benefit from either shortened or extended treatment duration. Furthermore, trials evaluating novel antithrombotic strategies, such as P2Y(12) inhibitor monotherapy, low-dose factor Xa inhibitors on top of antiplatelet therapy, and platelet function- or genotype-guided (de-)escalation of treatment, have shown promising results. Current guidelines recommend risk stratification for tailoring treatment duration and composition. Although several risk stratification methods evaluating ischaemic and bleeding risk are available to clinicians, such as the use of risk scores, platelet function testing, and genotyping, risk stratification has not been broadly adopted in clinical practice. Multiple risk scores have been developed to determine the optimal treatment duration, but external validation studies have yielded conflicting results in terms of calibration and discrimination and there is limited evidence that their adoption improves clinical outcomes. Likewise, platelet function testing and genotyping can provide useful prognostic insights, but trials evaluating treatment strategies guided by these stratification methods have produced mixed results. This review critically appraises the currently available antithrombotic strategies and provides a viewpoint on the use of different risk stratification methods alongside clinical judgement in current clinical practice. [GRAPHICS]
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- Dual antiplatelet therapy
- Patient-tailored antithrombotic therapy
- Risk stratification
Publication and Content Type
- ref (subject category)
- for (subject category)
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van der Sangen, ...
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Rozemeijer, Rik
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Yin, Dean R. P. ...
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Valgimigli, Marc ...
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Windecker, Steph ...
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James, Stefan, 1 ...
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Buccheri, Sergio
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ten Berg, Jurrie ...
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Henriques, Jose ...
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Voskuil, Michiel
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Kikkert, Wouter ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
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European Heart J ...
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Uppsala University