The optimal pharmacological formula for percutaneous coronary intervention.
BACKGROUND
Adjunctive pharmacotherapy is of key importance in determining the outcomes of percutaneous coronary intervention (PCI). In parallel, there has been an increasing body of evidence indicating that the aggressive management of coronary risk factors and changes in lifestyle behavior yield additional positive results in morbidity and mortality reductions. A stream of new data from randomized clinical trials has recently prompted the release of a focused update of the PCI guidelines, endorsing new recommendations on the use of antiplatelet drugs and parenteral anticoagulants.


METHODS
The aim of this manuscript is to provide an up-to-date overview of the current evidence on the use of adjunctive pharmacological therapy in patients undergoing revascularization, with focus on results of recent trials and future directions.


CONCLUSIONS
Given the availability of several pharmacological agents with different mechanisms of action, understanding whether a drug should or should not be prescribed, as well as individualizing the pharmacological formula to the patient's need and risk category, is pivotal to balance the safety and efficacy of adjunctive therapies for PCI. Studies on new antiplatelet agents and selective inhibitors of specific coagulation factors are likely to characterize the next years of research on interventional pharmacology.
University of Catania, Ferrarotto Hospital, Via Citelli, 6, 95124 Catania, Italy.
Davide
D
Capodanno
Corrado
C
Tamburino
George
G
Dangas
D015906:Angioplasty, Balloon, Coronary; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005260:Female; D005343:Fibrinolytic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D040242:Risk Reduction Behavior
D000925:Anticoagulants; D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors