title: Antiplatelet and Anticoagulation Treatment in Patients with Thrombocytopenia.
abstract: Thrombocytopenia (TP) is a common finding in patients hospitalized for cardiovascular causes and needing antiplatelet and anticoagulant therapies. However, TP is not only a numeric parameter, but mostly a dynamic condition affected by the patients' underlying disorders and concomitant treatments. Platelets are important players in the hemostatic process, taking part to both primary and secondary hemostasis. Although both TP and antithrombotic treatment contribute to the risk of bleeding, the complexity of the pathogenesis of bleeding events makes it difficult to predict them accurately simply based on these two parameters. It should be considered that, under certain clinical conditions, TP may be associated with an increased risk of thrombosis. In order to manage antithrombotic therapies in patients with TP, the frail balance between bleeding and thrombotic complications needs to be estimated. A joint hematological and cardiological evaluation is mandatory in order to avoid stopping an otherwise lifesaving treatment and to decrease the individual patient risk for both thrombotic and/or bleeding events, in each different setting. The purpose of this review is to describe an operative work flow aimed at helping clinicians to face this challenging issue.
authors.affiliation: Dipartimento Cardio-toracovascolare, SS UTIC/ SC Cardiologia 1-Emodinamica, ASST Grande Ospedale  Metropolitano Niguarda, Piazza Ospedale Maggiore, 3, Milan 20162, Italy.
authors.forename: Nuccia
authors.initials: N
authors.lastname: Morici
authors.forename: Silvia
authors.initials: S
authors.lastname: Cantoni
authors.forename: Paola
authors.initials: P
authors.lastname: Vallerio
authors.forename: Marco
authors.initials: M
authors.lastname: Cattaneo
authors.forename: Stefano
authors.initials: S
authors.lastname: Savonitto
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use*; D006470:Hemorrhage / Q000188:drug therapy; D006801:Humans; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D013921:Thrombocytopenia / Q000188:drug therapy*; D013927:Thrombosis / Q000188:drug therapy
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors
keywords: Antiplatelet; anticoagulant agents; bleeding complications; thrombocytopenia; thrombosis