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Bleeding Risk in Patients with Peripheral Arterial Disease

Patients with peripheral arterial disease (PAD) are at high risk of major adverse cardiac events (MACE) and major adverse limb events (MALE). Recently, antithrombotic therapies employing antiplatelet and anticoagulant drugs have proven to be valid in reducing MACE in patients with PAD and polyvascul...

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Autores principales: Visonà, Adriana, Zurlo, Chiara, Panzavolta, Chiara, Gobbo, Annachiara, Zalunardo, Beniamino
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9861549/
https://www.ncbi.nlm.nih.gov/pubmed/36675996
http://dx.doi.org/10.3390/life13010047
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author Visonà, Adriana
Zurlo, Chiara
Panzavolta, Chiara
Gobbo, Annachiara
Zalunardo, Beniamino
author_facet Visonà, Adriana
Zurlo, Chiara
Panzavolta, Chiara
Gobbo, Annachiara
Zalunardo, Beniamino
author_sort Visonà, Adriana
collection PubMed
description Patients with peripheral arterial disease (PAD) are at high risk of major adverse cardiac events (MACE) and major adverse limb events (MALE). Recently, antithrombotic therapies employing antiplatelet and anticoagulant drugs have proven to be valid in reducing MACE in patients with PAD and polyvascular disease and MALE, particularly in patients who have already been revascularized and remain at increased risk of MALE. However, more aggressive antithrombotic therapies lead to an increased risk of bleeding. Antithrombotic therapy and revascularization procedures entail an increased hemorrhagic risk that is also linked to having received more vigorous antithrombotic therapies. Therefore, it appears crucial to have specifically targeted scores for a PAD patient to assess bleeding and thrombotic risks. The correct utilization of a risk score will determine the variable risk factors for bleeding that can be corrected or modified, as well as identify patients at high risk that require regular reexamination and follow-up. Clinical risk scores do not represent the absolute reality, and inter-score variability must be taken into account. Moreover, several risk scores have been created to be basic and to facilitate and improve clinical decisions in daily practice. Many risk scores based on points vary according to the configuration of the studies, population type, and ethnic group, and many of the risk factor elements in a specific score are unlikely to sustain same weight for that risk. The best approach continues to be devising an uncomplicated, functional, validated, and precise score that can be adjusted to different clinical contexts and populations, while considering the mutable composition of clinical risk.
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spelling pubmed-98615492023-01-22 Bleeding Risk in Patients with Peripheral Arterial Disease Visonà, Adriana Zurlo, Chiara Panzavolta, Chiara Gobbo, Annachiara Zalunardo, Beniamino Life (Basel) Review Patients with peripheral arterial disease (PAD) are at high risk of major adverse cardiac events (MACE) and major adverse limb events (MALE). Recently, antithrombotic therapies employing antiplatelet and anticoagulant drugs have proven to be valid in reducing MACE in patients with PAD and polyvascular disease and MALE, particularly in patients who have already been revascularized and remain at increased risk of MALE. However, more aggressive antithrombotic therapies lead to an increased risk of bleeding. Antithrombotic therapy and revascularization procedures entail an increased hemorrhagic risk that is also linked to having received more vigorous antithrombotic therapies. Therefore, it appears crucial to have specifically targeted scores for a PAD patient to assess bleeding and thrombotic risks. The correct utilization of a risk score will determine the variable risk factors for bleeding that can be corrected or modified, as well as identify patients at high risk that require regular reexamination and follow-up. Clinical risk scores do not represent the absolute reality, and inter-score variability must be taken into account. Moreover, several risk scores have been created to be basic and to facilitate and improve clinical decisions in daily practice. Many risk scores based on points vary according to the configuration of the studies, population type, and ethnic group, and many of the risk factor elements in a specific score are unlikely to sustain same weight for that risk. The best approach continues to be devising an uncomplicated, functional, validated, and precise score that can be adjusted to different clinical contexts and populations, while considering the mutable composition of clinical risk. MDPI 2022-12-23 /pmc/articles/PMC9861549/ /pubmed/36675996 http://dx.doi.org/10.3390/life13010047 Text en © 2022 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
Visonà, Adriana
Zurlo, Chiara
Panzavolta, Chiara
Gobbo, Annachiara
Zalunardo, Beniamino
Bleeding Risk in Patients with Peripheral Arterial Disease
title Bleeding Risk in Patients with Peripheral Arterial Disease
title_full Bleeding Risk in Patients with Peripheral Arterial Disease
title_fullStr Bleeding Risk in Patients with Peripheral Arterial Disease
title_full_unstemmed Bleeding Risk in Patients with Peripheral Arterial Disease
title_short Bleeding Risk in Patients with Peripheral Arterial Disease
title_sort bleeding risk in patients with peripheral arterial disease
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9861549/
https://www.ncbi.nlm.nih.gov/pubmed/36675996
http://dx.doi.org/10.3390/life13010047
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