Antithrombotic strategies in patients on oral anticoagulant therapy undergoing percutaneous coronary intervention: a proposed algorithm based on individual risk stratification.
An increasing number of patients on chronic oral anticoagulant therapy undergo percutaneous coronary intervention. There is a lack of evidence-based data and no practice guidelines are available about the optimal antithrombotic treatment of such patients after the procedure; thus, the adopted strategies are highly variable and are often left to the discretion of the attending physician. In this article, we review current evidence and propose an algorithm of antithrombotic strategies tailored to the individual patient, which takes into account the relative risks of bleeding, ischemic complications, and thromboembolism.
Patti
Giuseppe
G
Department of Cardiovascular Sciences, Campus Bio-Medico University of Rome, Via Alvaro del Portillo, Rome, Italy.
Di Sciascio
Germano
G
D000284:Administration, Oral; D000465:Algorithms; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects; D000925:Anticoagulants / Q000008:administration & dosage / Q000009:adverse effects*; D003661:Decision Support Techniques; D019317:Evidence-Based Medicine; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D006470:Hemorrhage / Q000139:chemically induced*; D006801:Humans; D009203:Myocardial Infarction / Q000209:etiology; D018579:Patient Selection; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D017410:Practice Guidelines as Topic; D018570:Risk Assessment; D012307:Risk Factors; D013927:Thrombosis / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome
D000925:Anticoagulants; D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors