Antithrombotic treatment of asymptomatic carotid atherosclerosis: a medical dilemma

被引：12

作者：

Gresele, Paolo ^{[1
]}

Paciullo, Francesco ^{[1
]}

Migliacci, Rino ^{[2
]}

机构：

[1] Univ Perugia, Dept Med, Sect Internal & Cardiovasc Med, Str Vicinale,Via Corse, I-06132 Perugia, Italy

[2] Osped Valdichiana S Margherita, Div Internal Med, Cortona, Italy

来源：

INTERNAL AND EMERGENCY MEDICINE | 2020年 / 15卷 / 07期

关键词：

Antiplatelet; Aspirin; Asymptomatic carotid artery stenosis; Cardiovascular risk; Primary prevention; PERIPHERAL ARTERIAL-DISEASE; DUAL-ANTIPLATELET THERAPY; ASSOCIATION TASK-FORCE; PRIMARY PREVENTION; CARDIOVASCULAR EVENTS; STROKE RISK; AMERICAN-COLLEGE; PREDICTIVE-VALUE; MATRIX METALLOPROTEINASES; CORONARY ATHEROSCLEROSIS;

D O I：

10.1007/s11739-020-02347-7

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Carotid artery atherosclerosis (CAAS) is a common finding in asymptomatic subjects evaluated for cardiovascular (CV)-risk stratification. Besides the careful control of CV-risk factors, antithrombotic agents, and in particular aspirin, may be considered for primary prevention in patients at CV-risk. However, there is strong controversy on the use of aspirin in primary prevention. Even if several studies confirmed the association between CAAS and CV-events, CAAS is not universally recognized as an independent risk factor and the choice to use aspirin as primary prevention in these patients remains a medical dilemma. Here we review the available evidence on the prognostic value of asymptomatic CAAS for major CV-events and on the utility of antithrombotic agents in this population. We conclude that the detection of asymptomatic CAAS can not be considered as a direct indication to carry out primary prophylaxis with antithrombotic drugs, and the choice to use aspirin should be made only after the careful estimate of the individual's CV-and hemorrhagic risk.

引用

页码：1169 / 1181

页数：13

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