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Antithrombotic Therapy in Patients with Coronary Artery Disease and Prior Stroke
Patients with coronary artery disease (CAD) and prior cerebrovascular events (CVE) are frequently faced in clinical practice and present a high rate of both ischemic and bleeding events. For these reasons, the antithrombotic management is particularly challenging in this subgroup of patients. Recent...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8124359/ https://www.ncbi.nlm.nih.gov/pubmed/33946834 http://dx.doi.org/10.3390/jcm10091923 |
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author | Bellettini, Elisa De Luca, Leonardo |
author_facet | Bellettini, Elisa De Luca, Leonardo |
author_sort | Bellettini, Elisa |
collection | PubMed |
description | Patients with coronary artery disease (CAD) and prior cerebrovascular events (CVE) are frequently faced in clinical practice and present a high rate of both ischemic and bleeding events. For these reasons, the antithrombotic management is particularly challenging in this subgroup of patients. Recent trials suggest that, although a potent antiplatelet strategy is safe in the acute phases of myocardial ischemia for these patients, the risk of major bleeding complications, including intracranial hemorrhage, is extremely high when the antithrombotic therapy is prolonged for a long period of time. Therefore, especially in patients with chronic CAD and history of CVE, the antithrombotic management should be carefully balanced between ischemic and bleeding risks. The present review is aimed at critically evaluating the available evidence to help make these crucial clinical decisions regarding the better antithrombotic therapy to use in this high-risk subgroup of patients. |
format | Online Article Text |
id | pubmed-8124359 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-81243592021-05-17 Antithrombotic Therapy in Patients with Coronary Artery Disease and Prior Stroke Bellettini, Elisa De Luca, Leonardo J Clin Med Review Patients with coronary artery disease (CAD) and prior cerebrovascular events (CVE) are frequently faced in clinical practice and present a high rate of both ischemic and bleeding events. For these reasons, the antithrombotic management is particularly challenging in this subgroup of patients. Recent trials suggest that, although a potent antiplatelet strategy is safe in the acute phases of myocardial ischemia for these patients, the risk of major bleeding complications, including intracranial hemorrhage, is extremely high when the antithrombotic therapy is prolonged for a long period of time. Therefore, especially in patients with chronic CAD and history of CVE, the antithrombotic management should be carefully balanced between ischemic and bleeding risks. The present review is aimed at critically evaluating the available evidence to help make these crucial clinical decisions regarding the better antithrombotic therapy to use in this high-risk subgroup of patients. MDPI 2021-04-29 /pmc/articles/PMC8124359/ /pubmed/33946834 http://dx.doi.org/10.3390/jcm10091923 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Bellettini, Elisa De Luca, Leonardo Antithrombotic Therapy in Patients with Coronary Artery Disease and Prior Stroke |
title | Antithrombotic Therapy in Patients with Coronary Artery Disease and Prior Stroke |
title_full | Antithrombotic Therapy in Patients with Coronary Artery Disease and Prior Stroke |
title_fullStr | Antithrombotic Therapy in Patients with Coronary Artery Disease and Prior Stroke |
title_full_unstemmed | Antithrombotic Therapy in Patients with Coronary Artery Disease and Prior Stroke |
title_short | Antithrombotic Therapy in Patients with Coronary Artery Disease and Prior Stroke |
title_sort | antithrombotic therapy in patients with coronary artery disease and prior stroke |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8124359/ https://www.ncbi.nlm.nih.gov/pubmed/33946834 http://dx.doi.org/10.3390/jcm10091923 |
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