| Major bleeding: management and risk reduction in acute coronary syndromes. | |
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MedLine Citation:
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PMID: 18627326 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Guidelines for the management of high-risk non ST-segment elevation acute coronary syndrome (NSTE ACS) recommend antithrombotic and antiplatelet therapy combined with an early invasive strategy. While this strategy reduces ischemic complications, it places patients at risk for bleeding complications. OBJECTIVE: We sought to provide a narrative review of the risk factors for bleeding, risks associated with bleeding and strategies to prevent bleeding complications. METHODS: A comprehensive literature review was performed to identify relevant evidence. RESULTS/CONCLUSIONS: Bleeding complications in NSTE ACS are associated with adverse events and higher mortality. Prevention of bleeding complications can be achieved through judicious dosing of medications, the use of antithrombotic agents associated with a lower bleeding risk and use of the radial artery approach in patients requiring coronary intervention. Future work should focus on delineating the mechanisms underlying the bleeding-mortality relationship and developing a better understanding of the tradeoff between efficacy and safety. |
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Authors:
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Matthew A Cavender; Sunil V Rao; E Magnus Ohman |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Expert opinion on pharmacotherapy Volume: 9 ISSN: 1744-7666 ISO Abbreviation: Expert Opin Pharmacother Publication Date: 2008 Aug |
Date Detail:
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Created Date: 2008-07-16 Completed Date: 2008-09-15 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100897346 Medline TA: Expert Opin Pharmacother Country: England |
Other Details:
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Languages: eng Pagination: 1869-83 Citation Subset: IM |
Affiliation:
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Duke University Medical Center, Department of Medicine, Box 31110 Durham, NC 27710, USA. matt.cavender@duke.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Acute Coronary Syndrome
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drug therapy Angioplasty, Transluminal, Percutaneous Coronary / adverse effects, methods Clinical Trials as Topic Fibrinolytic Agents / adverse effects*, therapeutic use Hemorrhage / chemically induced*, prevention & control Humans Platelet Aggregation Inhibitors / adverse effects*, therapeutic use Practice Guidelines as Topic Radial Artery / metabolism Risk Factors |
| Chemical | |
Reg. No./Substance:
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0/Fibrinolytic Agents; 0/Platelet Aggregation Inhibitors |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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