Document Detail

Evaluating The Bite of BARC.
MedLine Citation:
PMID:  22344038     Owner:  NLM     Status:  Publisher    
Therapeutic options for patients with acute coronary syndrome (ACS) and those undergoing percutaneous coronary intervention (PCI) have evolved significantly over the past decade. In the era when there were limited antithrombotic choices, reduction of ischemic events was the primary goal regardless of the risk of bleeding that was associated with the use of antiplatelet and anticoagulant therapies. In the current era, clinicians are faced with five oral antiplatelet options (aspirin, ticlopidine, clopidogrel, prasugrel, ticagrelor), three intravenous antiplatelet agents (abciximab, eptifibatide, tirofiban), four anticoagulants (unfractionated heparin, low molecular weight heparin, bivalirudin, fondaparinux), and potentially additional oral anticoagulants for long-term secondary prevention(1). In general, the iterations in antithrombotic drugs have been directed at achieving greater potency; however, some agents, like fondaparinux and bivalirudin, were developed specifically in the context of maintaining antithrombotic efficacy but with better safety (i.e., lower bleeding risk)(2,3).The focus on bleeding risk is a relatively new development, and is likely driven by the robust literature demonstrating an association between bleeding during the management of ACS or in the setting of PCI and subsequent short- and long-term adverse outcomes such as myocardial infarction (MI), stroke, stent thrombosis, and death(4,5 )(SELECT FULL TEXT TO CONTINUE).
Sunil V Rao; Roxana Mehran
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-2-17
Journal Detail:
Title:  Circulation     Volume:  -     ISSN:  1524-4539     ISO Abbreviation:  -     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-2-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
1 The Duke Clinical Research Institute, Durham, NC;
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