The Role for Combined Antithrombotic Therapy with Platelet and Coagulation Inhibition After Lower Extremity Revascularization
Autor: | Manesh R. Patel, Sigrid Nikol, Rupert Bauersachs, Sebastian Debus, E. Hope Weissler, Victor Aboyans, W. Schuyler Jones, Marianne Brodmann |
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Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
medicine.medical_specialty
Combination therapy medicine.drug_class Disease 030204 cardiovascular system & hematology Article 03 medical and health sciences Peripheral Arterial Disease 0302 clinical medicine Fibrinolytic Agents Antithrombotic medicine Humans Platelet 030212 general & internal medicine Intensive care medicine Rivaroxaban business.industry Anticoagulant food and beverages Guideline Treatment Outcome Coagulation Lower Extremity Cardiology and Cardiovascular Medicine business Vascular Surgical Procedures medicine.drug |
Zdroj: | JACC Cardiovasc Interv |
Popis: | Evidence for antithrombotic treatment following lower extremity revascularization (LER) for peripheral artery disease (PAD) is limited, leading to weak and conflicting guideline recommendations and heterogeneous practice patterns. This variability in post-LER antithrombotic treatment raises quality-of-care issues that have long been under-studied. This Viewpoint reviews the most updated guidelines, currently-available evidence, and contemporary data about practice patterns and practitioner opinions in this area. Particular attention is paid to distinctions between antiplatelet therapy, anticoagulant therapy, and combination therapy in light of the recent VOYAGER-PAD (Vascular Outcomes Study of ASA [acetylsalicylic acid] Along with Rivaroxaban in Endovascular or Surgical Limb Revascularization for PAD) trial. The implications of VOYAGER-PAD pertaining to various subgroups of patients undergoing LER are explored. Overall, this Viewpoint argues for consideration of post-LER therapy targeted at both platelet function and the coagulation cascade, though further LER-specific analyses, including expected VOYAGER-PAD sub-analyses, are needed. |
Databáze: | OpenAIRE |
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