Optimizing antithrombotic therapy after coronary stent implantation in patients on chronic oral anticoagulation

Naoual Bennaghmouch; D Sprenkeler; Khalid Qaderdan; J M ten Berg

doi:10.1007/s12265-013-9536-2

Optimizing antithrombotic therapy after coronary stent implantation in patients on chronic oral anticoagulation

Naoual Bennaghmouch, D Sprenkeler, Khalid Qaderdan, J M ten Berg

Research output: Contribution to journal › Review article › peer-review

Abstract

Most patients on chronic oral anticoagulation have a lifelong indication. When these patients undergo percutaneous coronary interventions with stent implantation, they also have an indication for dual antiplatelet therapy (aspirin and a P2Y12 inhibitor). However, this so-called triple therapy results in increased bleeding risks which in turn is associated with increased mortality. Furthermore, emerging stronger antiplatelet drugs (prasugrel and ticagrelor) are associated with increased bleeding, making triple therapy even more hazardous. This created a clinical treatment dilemma for this subset of patients, and new trials have been designed to explore new treatment strategies. This review summarizes the available evidence regarding the optimal treatment of patients on chronic oral anticoagulation undergoing percutaneous coronary interventions with stent implantation.

Original language	English
Pages (from-to)	64-71
Number of pages	8
Journal	Journal of Cardiovascular Translational Research
Volume	7
Issue number	1
DOIs	https://doi.org/10.1007/s12265-013-9536-2
Publication status	Published - Feb 2014

Keywords

Administration, Oral
Anticoagulants
Coronary Artery Disease
Drug Administration Schedule
Drug Therapy, Combination
Fibrinolytic Agents
Hemorrhage
Humans
Patient Selection
Percutaneous Coronary Intervention
Practice Guidelines as Topic
Risk Assessment
Risk Factors
Stents
Time Factors
Treatment Outcome
Journal Article
Review

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10.1007/s12265-013-9536-2

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title = "Optimizing antithrombotic therapy after coronary stent implantation in patients on chronic oral anticoagulation",

abstract = "Most patients on chronic oral anticoagulation have a lifelong indication. When these patients undergo percutaneous coronary interventions with stent implantation, they also have an indication for dual antiplatelet therapy (aspirin and a P2Y12 inhibitor). However, this so-called triple therapy results in increased bleeding risks which in turn is associated with increased mortality. Furthermore, emerging stronger antiplatelet drugs (prasugrel and ticagrelor) are associated with increased bleeding, making triple therapy even more hazardous. This created a clinical treatment dilemma for this subset of patients, and new trials have been designed to explore new treatment strategies. This review summarizes the available evidence regarding the optimal treatment of patients on chronic oral anticoagulation undergoing percutaneous coronary interventions with stent implantation.",

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author = "Naoual Bennaghmouch and D Sprenkeler and Khalid Qaderdan and {ten Berg}, {J M}",

year = "2014",

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doi = "10.1007/s12265-013-9536-2",

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AU - Sprenkeler, D

AU - Qaderdan, Khalid

AU - ten Berg, J M

PY - 2014/2

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N2 - Most patients on chronic oral anticoagulation have a lifelong indication. When these patients undergo percutaneous coronary interventions with stent implantation, they also have an indication for dual antiplatelet therapy (aspirin and a P2Y12 inhibitor). However, this so-called triple therapy results in increased bleeding risks which in turn is associated with increased mortality. Furthermore, emerging stronger antiplatelet drugs (prasugrel and ticagrelor) are associated with increased bleeding, making triple therapy even more hazardous. This created a clinical treatment dilemma for this subset of patients, and new trials have been designed to explore new treatment strategies. This review summarizes the available evidence regarding the optimal treatment of patients on chronic oral anticoagulation undergoing percutaneous coronary interventions with stent implantation.

AB - Most patients on chronic oral anticoagulation have a lifelong indication. When these patients undergo percutaneous coronary interventions with stent implantation, they also have an indication for dual antiplatelet therapy (aspirin and a P2Y12 inhibitor). However, this so-called triple therapy results in increased bleeding risks which in turn is associated with increased mortality. Furthermore, emerging stronger antiplatelet drugs (prasugrel and ticagrelor) are associated with increased bleeding, making triple therapy even more hazardous. This created a clinical treatment dilemma for this subset of patients, and new trials have been designed to explore new treatment strategies. This review summarizes the available evidence regarding the optimal treatment of patients on chronic oral anticoagulation undergoing percutaneous coronary interventions with stent implantation.

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KW - Anticoagulants

KW - Coronary Artery Disease

KW - Drug Administration Schedule

KW - Drug Therapy, Combination

KW - Fibrinolytic Agents

KW - Hemorrhage

KW - Humans

KW - Patient Selection

KW - Percutaneous Coronary Intervention

KW - Practice Guidelines as Topic

KW - Risk Assessment

KW - Risk Factors

KW - Stents

KW - Time Factors

KW - Treatment Outcome

KW - Journal Article

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Optimizing antithrombotic therapy after coronary stent implantation in patients on chronic oral anticoagulation

Abstract

Keywords

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