Document Detail


Major bleeding: management and risk reduction in acute coronary syndromes.
MedLine Citation:
PMID:  18627326     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Matthew A Cavender; Sunil V Rao; E Magnus Ohman
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Expert opinion on pharmacotherapy     Volume:  9     ISSN:  1744-7666     ISO Abbreviation:  Expert Opin Pharmacother     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-07-16     Completed Date:  2008-09-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100897346     Medline TA:  Expert Opin Pharmacother     Country:  England    
Other Details:
Languages:  eng     Pagination:  1869-83     Citation Subset:  IM    
Affiliation:
Duke University Medical Center, Department of Medicine, Box 31110 Durham, NC 27710, USA. matt.cavender@duke.edu
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MeSH Terms
Descriptor/Qualifier:
Acute Coronary Syndrome / 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:
0/Fibrinolytic Agents; 0/Platelet Aggregation Inhibitors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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