Antithrombotic strategies in patients on oral anticoagulant therapy undergoing percutaneous coronary intervention: a proposed algorithm based on individual risk stratification

Catheter Cardiovasc Interv. 2010 Jan 1;75(1):128-34. doi: 10.1002/ccd.22200.

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.

Publication types

  • Review

MeSH terms

  • Administration, Oral
  • Algorithms*
  • Angioplasty, Balloon, Coronary* / adverse effects
  • Anticoagulants / administration & dosage
  • Anticoagulants / adverse effects*
  • Decision Support Techniques*
  • Evidence-Based Medicine
  • Fibrinolytic Agents / administration & dosage
  • Fibrinolytic Agents / adverse effects*
  • Hemorrhage / chemically induced*
  • Humans
  • Myocardial Infarction / etiology
  • Patient Selection
  • Platelet Aggregation Inhibitors / administration & dosage
  • Platelet Aggregation Inhibitors / adverse effects*
  • Practice Guidelines as Topic
  • Risk Assessment
  • Risk Factors
  • Thrombosis / etiology
  • Thrombosis / prevention & control*
  • Treatment Outcome

Substances

  • Anticoagulants
  • Fibrinolytic Agents
  • Platelet Aggregation Inhibitors