Document Detail

The balance between anti-ischemic efficacy and bleeding risk of antithrombotic therapy in percutaneous coronary intervention: a Yin-Yang paradigm.
MedLine Citation:
PMID:  20516510     Owner:  NLM     Status:  MEDLINE    
The development of newer and more potent antithrombotic agents and strategies has markedly reduced cardiovascular mortality and ischemic complications in patients with acute coronary syndromes and those undergoing percutaneous coronary intervention (PCI). With every approach to reduce coronary thrombosis, however, there is an accompanying risk of increasing bleeding complications elsewhere. Conversely, reducing bleeding complications may increase coronary thrombotic (ischemic) events. This is the Yin-Yang principle of antithrombotic therapy and strategies in PCI. Balancing both ends of the spectrum is essential, and an individualized approach to therapy is advocated. This article reviews the efficacy and bleeding risk profile of the different antithrombotic agents and strategies in PCI, including aspirin, thienopyridines, glycoprotein IIb/IIIa-inhibitors, heparin-based antithrombins, synthetic antithrombins and oral anticoagulants. Recommendations for reducing thrombotic and bleeding complications are also discussed.
Joel A Lardizabal; Bipin K Joshi; John A Ambrose
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The Journal of invasive cardiology     Volume:  22     ISSN:  1557-2501     ISO Abbreviation:  J Invasive Cardiol     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-06-02     Completed Date:  2010-09-16     Revised Date:  2013-05-20    
Medline Journal Info:
Nlm Unique ID:  8917477     Medline TA:  J Invasive Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  284-92     Citation Subset:  IM    
Cardiology Division, Department of Medicine, UCSF School of Medicine, Fresno MEP, Fresno, California 93721, USA.
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MeSH Terms
Angioplasty, Balloon, Coronary*
Combined Modality Therapy
Coronary Thrombosis / drug therapy,  epidemiology
Fibrinolytic Agents / administration & dosage*,  adverse effects
Hemorrhage / chemically induced,  epidemiology*
Myocardial Ischemia / epidemiology*,  therapy*
Risk Factors
Reg. No./Substance:
0/Fibrinolytic Agents

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