Management of Acute Coronary Syndrome in Patients with Liver Cirrhosis
| Autor: | Adrian W. Messerli, Taha Ahmed, Alla Grigorian |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Cirrhosis medicine.medical_treatment Population 030204 cardiovascular system & hematology Revascularization law.invention 03 medical and health sciences 0302 clinical medicine Pharmacotherapy Randomized controlled trial law Antithrombotic medicine Pharmacology (medical) 030212 general & internal medicine Risk factor education Intensive care medicine education.field_of_study Management of acute coronary syndrome business.industry General Medicine medicine.disease Cardiology and Cardiovascular Medicine business |
| Zdroj: | American Journal of Cardiovascular Drugs. 22:55-67 |
| ISSN: | 1179-187X 1175-3277 |
| Popis: | Liver cirrhosis (LC) is becoming increasingly common among patients presenting with acute coronary syndromes (ACS) and is associated with significant cardiovascular morbidity and mortality. Management of such patients is complicated by LC related complications. Literature is scarce on the safety of antithrombotic regimens and invasive strategies for ACS in patients with LC, especially those undergoing liver transplant evaluation. Recently there has been evidence that cirrhosis is an independent risk factor for adverse outcomes in ACS. As patients with LC are generally excluded from large randomized trials, definitive guidelines for the management of ACS in this particular cohort are lacking. Many antithrombotic drugs require either hepatic activation or clearance; hence, an accurate assessment of hepatic function is required prior to initiation and dose adjustment. Despite a demonstrated survival benefit of optimal medical therapy and invasive revascularization techniques in LC patients with ACS, both strategies are currently underutilized in this population. This review aims to present currently available data and provide a practical, clinically oriented approach for the management of ACS in LC. Randomized clinical trials in LC patients with ACS are the need of the hour to further refine their management for favorable outcomes. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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