Abstract
An increasing number of patients on chronic oral anticoagulant therapy undergo percutaneous coronary intervention. There is a lack of evidence-based data and no practice guidelines are available about the optimal antithrombotic treatment of such patients after the procedure; thus, the adopted strategies are highly variable and are often left to the discretion of the attending physician. In this article, we review current evidence and propose an algorithm of antithrombotic strategies tailored to the individual patient, which takes into account the relative risks of bleeding, ischemic complications, and thromboembolism.
Copyright 2009 Wiley-Liss, Inc.
MeSH terms
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Administration, Oral
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Algorithms*
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Angioplasty, Balloon, Coronary* / adverse effects
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Anticoagulants / administration & dosage
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Anticoagulants / adverse effects*
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Decision Support Techniques*
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Evidence-Based Medicine
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Fibrinolytic Agents / administration & dosage
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Fibrinolytic Agents / adverse effects*
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Hemorrhage / chemically induced*
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Humans
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Myocardial Infarction / etiology
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Patient Selection
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Platelet Aggregation Inhibitors / administration & dosage
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Platelet Aggregation Inhibitors / adverse effects*
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Practice Guidelines as Topic
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Risk Assessment
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Risk Factors
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Thrombosis / etiology
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Thrombosis / prevention & control*
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Treatment Outcome
Substances
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Anticoagulants
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Fibrinolytic Agents
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Platelet Aggregation Inhibitors