[Discontinuation of treatment with platelet aggregation inhibitors in surgical patients with cardiac stents].
Dual antiplatelet therapy with aspirin and clopidogrel is increasingly used for secondary prevention of cardiovascular events in patients with percutaneous coronary intervention. Anesthesiologists and surgeons are faced with the challenge of managing these patients prior to a surgical procedure. Premature discontinuation of antiplatelet therapy constitutes a substantial risk of stent thrombosis, myocardial infarction and death. Continuing therapy increases the risk of bleeding. We provide the latest evidence on this topic for patients awaiting non-cardiac surgery.
Johansen
Mathias
M
Anaestesiologisk og Intensiv Afdeling, Hvidovre Hospital, DK-2650 Hvidovre, Denmark. mattisboy@webspeed.dk
Afshari
Arash
A
Kristensen
Billy B
BB
D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects; D001241:Aspirin / Q000008:administration & dosage; D016063:Blood Loss, Surgical; D000077144:Clopidogrel; D003328:Coronary Thrombosis / Q000209:etiology / Q000517:prevention & control; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D017558:Elective Surgical Procedures; D004630:Emergencies; D019317:Evidence-Based Medicine; D006801:Humans; D009203:Myocardial Infarction / Q000209:etiology / Q000517:prevention & control; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D019106:Postoperative Hemorrhage / Q000209:etiology; D017410:Practice Guidelines as Topic; D018570:Risk Assessment; D015607:Stents / Q000009:adverse effects; D013988:Ticlopidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D013997:Time Factors
D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin