| Combining antiplatelet and anticoagulant therapies. | |
| | |
MedLine Citation:
|
PMID: 19573725 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
Antiplatelet therapy is the cornerstone for both primary and secondary prevention therapies for ischemic events resulting from coronary atherosclerotic disease. Dual antiplatelet therapy (aspirin plus a thienopyridine, usually clopidogrel) has assumed a central role in the treatment of acute coronary syndromes and after coronary stent deployment. In addition to antiplatelet therapy, anticoagulant therapy might be indicated for stroke prevention in a variety of conditions that include atrial fibrillation, profound left ventricular dysfunction, and after mechanical prosthetic heart valve replacement. For this reason, the use of triple antithrombotic therapy (a dual antiplatelet regimen plus warfarin) is expected to become more prominent, given an aging patient population. But although triple therapy can prevent both thromboembolism and stent thrombosis, it is also associated with significant bleeding hazards. Furthermore, when bleeding events do occur, the challenge of balancing the risk of stent thrombosis or stroke and the need for hemostasis requires considerable expertise. It is both prudent and timely to review treatment strategies that employ combinations of antiplatelet and anticoagulant therapies as well as strategies aimed at reducing bleeding risk in patients treated with these therapies. |
| | |
Authors:
|
David R Holmes; Dean J Kereiakes; Neal S Kleiman; David J Moliterno; Giuseppe Patti; Cindy L Grines |
Related Documents
:
|
2310055 - Management of multiple cholesterol embolization syndrome--a case report. 6823685 - Evaluation of the risk of immediate anticoagulant treatment in patients with embolic st... 14699705 - Oral anticoagulant therapy in the primary and secondary prophylaxis of stroke. 7952425 - Lack of degradation of antithrombin iii by tissue-type plasminogen activator or plasmin. 642565 - Long-term survival after single aortic or mitral valve replacement with the present mod... 11520485 - Effectiveness of statins in acute coronary syndromes. |
Publication Detail:
|
Type: Journal Article; Review |
Journal Detail:
|
Title: Journal of the American College of Cardiology Volume: 54 ISSN: 1558-3597 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2009 Jul |
Date Detail:
|
Created Date: 2009-07-03 Completed Date: 2009-07-28 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
|
Languages: eng Pagination: 95-109 Citation Subset: AIM; IM |
Affiliation:
|
Mayo Clinic Department of Cardiovascular Diseases, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. holmes.david@mayo.edu |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Anticoagulants
/
therapeutic use* Coronary Artery Disease / blood, drug therapy* Drug Therapy, Combination Evidence-Based Medicine / methods Humans Platelet Aggregation Inhibitors / therapeutic use* Treatment Outcome |
| Chemical | |
Reg. No./Substance:
|
0/Anticoagulants; 0/Platelet Aggregation Inhibitors |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Intravascular ultrasound registration/integration with coronary angiography.
Next Document: Serial intravascular ultrasound analysis of the main and side branches in bifurcation lesions treate...