Tailoring Dual Antiplatelet Therapy for the Complex PCI Patient: Current Status and Perspectives

Autor: Despoina-Rafailia Benetou, Charalampos Varlamos, Dimitrios Alexopoulos, Ioannis Andreou
Rok vydání: 2020
Předmět:
0301 basic medicine
medicine.medical_specialty
Time Factors
medicine.medical_treatment
Coronary Artery Disease
030204 cardiovascular system & hematology
Total occlusion
Drug Administration Schedule
03 medical and health sciences
0302 clinical medicine
Percutaneous Coronary Intervention
Fibrinolytic Agents
High complexity
Risk Factors
Antithrombotic
Atrial Fibrillation
medicine
Humans
Pharmacology (medical)
In patient
cardiovascular diseases
Intensive care medicine
Pharmacology
High Ischemic Risk
business.industry
Dual Anti-Platelet Therapy
Percutaneous coronary intervention
Anticoagulants
Atrial fibrillation
General Medicine
medicine.disease
surgical procedures
operative
030104 developmental biology
Treatment Outcome
Coronary Occlusion
Conventional PCI
Stents
Cardiology and Cardiovascular Medicine
business
therapeutics
Platelet Aggregation Inhibitors
Zdroj: Cardiovascular drugs and therapy. 34(5)
ISSN: 1573-7241
Popis: Dual antiplatelet therapy (DAPT) duration in patients undergoing percutaneous coronary intervention (PCI) has long been considered a matter of controversy. Complex-PCI (C-PCI) is considered to be associated with an increased ischemic risk that tends to be greater with progressively higher procedural complexity. Thus, with a view to balance ischemic versus bleeding risks, high complexity of PCI intuitively represents an advocate of prolonged DAPT duration. However, the optimal DAPT strategy in this high ischemic risk subset of patients remains unclear, a fact that is exacerbated by the absence of a universal definition of C-PCI, resulting in a significant between-study heterogeneity. The aim of this review is to highlight the increased risks associated with C-PCI, compare long- versus short-term DAPT regimens regarding safety and efficacy endpoints as well as investigate outcomes in special C-PCI cohorts, such as patients with bifurcation, left main or chronic total occlusion lesions. Furthermore, controversial issues, such as antithrombotic regimens in C-PCI patients with atrial fibrillation, and future perspectives are addressed.
Databáze: OpenAIRE
Externí odkaz: