Atrial fibrillation and ischaemic heart disease: should we use acetylsalicylic acid beside anticoagulants?
| Autor: | Giovanna Gallo, Massimo Volpe |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Acute coronary syndrome Ischaemic cardiomyopathy medicine.drug_class medicine.medical_treatment Ischemia 030204 cardiovascular system & hematology Revascularization Dual antiplatelet treatment 03 medical and health sciences 0302 clinical medicine P2Y12 dual antiplatelet treatment atrial fibrillation ischaemic cardiomyopathy oral anticoagulants Internal medicine Diabetes mellitus medicine AcademicSubjects/MED00200 030212 general & internal medicine Aspirin business.industry Anticoagulant Atrial fibrillation Articles medicine.disease Oral anticoagulants Cardiology Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | European Heart Journal Supplements : Journal of the European Society of Cardiology |
| ISSN: | 1554-2815 1520-765X |
| Popis: | Coexistence of atrial fibrillation and ischaemic heart disease is very common and patients affected by these conditions are exposed to both a high ischaemic and haemorrhagic risk. The choice of an appropriate combination of anticoagulant therapy with single or dual antiplatelet treatment is indeed one of the most relevant and contemporary challenges in clinical practice. Several studies and meta-analyses pointed out that 1 year after an acute coronary syndrome or percutaneous revascularization, the use of the sole anticoagulant therapy is not associated with increased risk of major cardiovascular events, whereas there is a substantial reduction of clinical significant bleeding events, as compared to patients treated also with antiplatelet medications. However, there are no clear-cut data regarding the possibility to implement this strategy in each patient, regardless the cardiovascular risk class. Furthermore, for patients requiring a combined anticoagulant and antiplatelet treatment, the available data seem to favour an association of direct anticoagulant and inhibitors of P2Y12, rather than regimens including aspirin. These data are derived mainly from observational studies, with all their limitations. The use of aspirin could be beneficial in patients with significant comorbidities, such as diabetes mellitus, or with severe peripheral atherosclerotic disease, involving the carotids and other large arteries. |
| Databáze: | OpenAIRE |
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