title: The risk of bleeding with the use of antiplatelet agents for the treatment of cardiovascular disease.
abstract: In the presence of injured coronary vascular endothelium, platelets become activated to form hemostatic plugs. While this represents a normal healing response to disrupted vascular endothelium, occlusive cardiovascular disease, as a result of maladaptive thrombus formation, is a major cause of morbidity and mortality. Due to the platelet predominance of arterial thrombi, antiplatelet agents are the mainstay of therapy for arterial cardiovascular disease, though come with a significantly increased risk of bleeding. Areas covered: This review will provide a comprehensive overview of available antiplatelet agents used to treat coronary artery cardiovascular disease. The risks of bleeding with each agent will be considered. Expert opinion: Available antiplatelet therapies are effective in treating acute thrombotic events and preventing recurrent events, however, they also carry significant bleeding risks. The decision to use or continue antiplatelet agents remains challenging for physicians and necessitates a thorough understanding of the future risk of thrombotic risks of thrombotic or bleeding events in a patient. Clinical prediction rules and risk scores may be useful to support physician decision-making.
authors.affiliation: a Resident in Internal Medicine , Brigham and Women's Hospital , Boston , MA , USA.
authors.forename: Ashwin S
authors.initials: AS
authors.lastname: Nathan
authors.affiliation: b Resident in Internal Medicine , Massachusetts General Hospital , Boston , MA , USA.
authors.forename: Sounok
authors.initials: S
authors.lastname: Sen
authors.affiliation: a Resident in Internal Medicine , Brigham and Women's Hospital , Boston , MA , USA.|c Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center , Boston , MA , USA.
authors.forename: Robert W
authors.initials: RW
authors.lastname: Yeh
mesh_terms: D001792:Blood Platelets / Q000187:drug effects / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000188:drug therapy* / Q000503:physiopathology; D003324:Coronary Artery Disease / Q000188:drug therapy / Q000503:physiopathology; D003657:Decision Making; D006470:Hemorrhage / Q000139:chemically induced* / Q000453:epidemiology; D006801:Humans; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D012306:Risk; D013927:Thrombosis / Q000188:drug therapy / Q000517:prevention & control
chemical_list: D010975:Platelet Aggregation Inhibitors
keywords: Antiplatelet; GPIIb/IIIa; PAR-1; aspirin; cardiovascular; clopidogrel; prasugrel; ticagrelor