Antiplatelet Therapy in High-Bleeding Risk Patients Undergoing PCI: Walking a Tightrope

Reviews in Cardiovascular Medicine

卷:23

Mohan Satish¹  Davis Jones¹  Johny Nicolas¹  Frans Beerkens¹  Roxana Mehran¹  Davide Cao¹  Daniel Feldman¹  Alessando Spirito¹ 

[1] The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, NY 10029-6574, US;

关键词: high bleeding risk;    hbr;    percutaneous coronary intervention;    antiplatelet therapy;    antithrombotic therapy;    dapt;   

DOI  :  10.31083/j.rcm2306207

来源: DOAJ

【 摘 要 】

Historically, prevention from ischemic events with dual antiplatelet therapy (DAPT) post percutaneous coronary intervention (PCI) took precedence over protection from bleeding. However, increasing data suggest that major bleeding complications are as detrimental as ischemic events. Awareness about the prognostic impact of bleeding prompted the search for new strategies aimed at maximizing both ischemic and bleeding protection. This is noteworthy because patients at high bleeding risk (HBR) have generally been underrepresented in clinical trials on DAPT and they often are at increased risk of ischemic events as well. The present review discusses the evidence base for new pharmacotherapeutic strategies to decrease bleeding risk without compromising ischemic protection among HBR patients undergoing PCI, including shortening DAPT duration, early aspirin withdrawal, and P2Y12 inhibitor de-escalation.

【 授权许可】

Unknown