Management of antiplatelet therapy for minimization of bleeding risk before cardiac surgery.
Antiplatelet therapy is commonly administered for primary and secondary prevention of stroke, recurrent angina, myocardial infarction, and death in patients with cardiovascular disorders. It also is associated with an increased risk of bleeding. We describe the management of antiplatelet therapy in patients undergoing coronary artery bypass graft surgery. In addition, we provide basic information about the mechanisms of action by which the most common antiplatelet agents inhibit platelet function. This information is integrated with results from pharmacologic studies and clinical trials. Determining the net effect in patients undergoing coronary artery bypass graft surgery requires knowledge about the pharmacokinetics, pharmacodynamics, and clinical efficacy of each drug, and an estimation of the absolute thrombotic versus hemorrhagic risk for each patient.
Weant
Kyle A
KA
University of North Carolina Hospitals and the School of Pharmacy, University of North Carolina, Chapel Hill, North Carolina, USA.
Flynn
Jeremy F
JF
Akers
Wendell S
WS
D000244:Adenosine Diphosphate / Q000037:antagonists & inhibitors; D001241:Aspirin / Q000627:therapeutic use; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001026:Coronary Artery Bypass; D003328:Coronary Thrombosis / Q000517:prevention & control; D006801:Humans; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors
D010975:Platelet Aggregation Inhibitors; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D000244:Adenosine Diphosphate; D001241:Aspirin