[Perioperative use of antithrombotic agents: recommendations of the American College of Chest Physicians (ACCP) and the French Superior Health Authority (HAS)].
The purpose of this work was to analyse management practices for patients given anticoagulants or antiplatelet agents such as aspirin, clopidogrel and who are to undergo an invasive procedure or surgery. The modalities for the transition from oral agents to low-molecular-weight-heparin (LMWH) or unfractionated heparin (UFH) are studied. The recommendations or suggestions using the ACCP score: grade 1 recommendations are strongly motivated and indicate whether the benefit overbalances or not the risk, the burden, and the cost of the treatment. Grade 2 recommendations are considered to be suggestions. They imply that the individual physician chooses between different therapeutic strategies. For the purpose of this work, the most important recommendations are the following:
Samama
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MM
Groupe interdisciplinaire Trousseau sur les antithrombotiques, unité hémostase-thrombose, Hôtel-Dieu, Parvis Notre-Dame, 75181 Paris cedex 04, France. MeyerMichel.SAMAMA@biomnis.com
Horellou
M H
MH
Achkar
A
A
Conard
J
J
D000925:Anticoagulants / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000150:complications; D006348:Cardiac Surgical Procedures / Q000379:methods*; D000077144:Clopidogrel; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D005602:France; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects; D006493:Heparin / Q000627:therapeutic use; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D012307:Risk Factors; D012955:Societies, Medical; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D014481:United States
D000925:Anticoagulants; D005343:Fibrinolytic Agents; D006495:Heparin, Low-Molecular-Weight; D010975:Platelet Aggregation Inhibitors; D006493:Heparin; D000077144:Clopidogrel; D013988:Ticlopidine