What We Know Dual antiplatelet therapy is the recommended treatment for all patients with an acute coronary syndrome treated or not treated with an invasive procedure.1–4 Several trials testing clopidogrel5–7 or new antiplatelet agents8,9 clearly showed that the addition of a thyenopiridine to aspirin is associated with a significant improvement of patients’ outcomes. Furthermore, even in the c...

The management of coronary patients scheduled for a coronary artery bypass grafting (CABG), who are receiving one or more antiplatelet drugs, is plenty of controversies. It has been shown that withdrawal of antiplatelet drugs is associated with an increased risk of a thrombotic event, but surgery under an altered platelet function also means an increased risk of bleeding in the perioperative pe...

Coronary and cerebrovascular atherothrombosis are the leading cause of mortality and morbidity worldwide. Novel antiplatelet agents have been established for the management of patients with clinically evident coronary atherothrombosis and are increasingly used in these patients. These agents, however, have shown limited efficacy in the prevention of cerebrovascular events and potential harm in ...

Antiplatelet agents are increasingly being used in the management of all types of atherosclerotic disease, and, accordingly, patients on them are presenting more frequently for anaesthesia. Presentations range from elective patients taking aspirin as monotherapy for primary prevention of cardiovascular morbidity, to those maintained on multiple therapies requiring salvage surgery after a cardio...

Gastrointestinal (GI) bleeding is a frequently encountered and very serious problem in emergency room patients who are currently being treated with anticoagulant or antiplatelet medications. There is, however, a lack of clinical practice guidelines about how to respond to these situations. The goal of this study was to find published articles that contain specific information about how to safel...

OBJECTIVE Prehospital use of antiplatelet agents has been associated with an increased risk for intracranial hemorrhage (ICH) as well as a secondary increase in ICH volume after the initial hemorrhage. Strategies to reestablish platelet aggregation are used in clinical practice, but without any established guidelines or recommendations. This article serves to evaluate the literature regarding "...

UNLABELLED In the present study we aimed to evaluate side effects of antiplatelet therapy in order to establish correlations with medication type, doses and association with other therapies. MATERIAL AND METHODS In the study we prospectively evaluated a cohort of patients who received antiplatelet therapy for different pathologies. We included patients with acute coronary syndromes, valvular ...

Network meta-analysis can provide estimates of treatment efficacy of multiple treatment regimens, even when direct comparisons are unavailable. We used network meta-analysis to compare commonly used antiplatelet regimens in the prevention of serious vascular events after transient ischaemic attack (TIA) or stroke. We performed direct meta-analyses of randomized, controlled trials evaluating ant...

PURPOSE Anesthesiologists managing patients with drug-eluting stents (DES) face the challenge of balancing the risks of bleeding vs perioperative stent thrombosis (ST). This article reviews DES and the influence of antiplatelet medications related to their use. A perioperative management algorithm is suggested. Novel P2Y12 antagonists currently under investigation, including cangrelor and prasu...