Use of Antiplatelet Therapy/DAPT for Post-PCI Patients Undergoing Noncardiac Surgery

被引：57

作者：

Banerjee, Subhash ^{[1
,2
]}

Angiolillo, Dominick J. ^{[3
]}

Boden, William E. ^{[4
]}

Murphy, Joseph G. ^{[5
]}

Khalili, Houman ^{[1
,2
]}

Hasan, Ahmed A. ^{[6
]}

Harrington, Robert A. ^{[7
]}

Rao, Sunil V. ^{[8
,9
]}

机构：

[1] Univ Texas Southwestern Med Ctr Dallas, Dallas, TX 75390 USA

[2] Vet Affairs North Texas Hlth Care Syst, Dallas, TX USA

[3] Univ Florida, Coll Med Jacksonville, Jacksonville, FL USA

[4] Vet Affairs New England Healthcare Syst, Boston, MA USA

[5] Mayo Clin, Rochester, MN USA

[6] NHLBI, Bldg 10, Bethesda, MD 20892 USA

[7] Stanford Univ, Sch Med, Stanford, CA 94305 USA

[8] Duke Univ, Sch Med, Durham, NC USA

[9] Durham VA Med Ctr, Durham, NC USA

来源：

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY | 2017年 / 69卷 / 14期

关键词：

aspirin; coronary balloon angioplasty; drug-eluting stents; risk assessment; stents; thrombosis; DRUG-ELUTING STENT; PERCUTANEOUS CORONARY INTERVENTION; CARDIAC EVENTS; PERIOPERATIVE MANAGEMENT; OUTCOMES; RISK; ASPIRIN; WITHDRAWAL; THROMBOSIS; CESSATION;

D O I：

10.1016/j.jacc.2017.02.012

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Dual antiplatelet therapy (DAPT) is prescribed to millions of patients worldwide following coronary stenting. DAPT is indicated to lower the risk of ischemic events, such as myocardial infarction, including stent thrombosis, ischemic stroke, or death from cardiovascular causes. A significant number of these patients undergo noncardiac surgery and may require DAPT interruption. This poses a significant clinical dilemma because DAPT interruption exposes patients to the potential risk of stent thrombosis, perioperative myocardial infarction, or both. Conversely, continuing DAPT may be associated with excess bleeding complications. Observational data in this area are conflicting, and there are no randomized clinical trials to guide practitioner decision making. On the basis of predominantly consensus recommendations, various strategies for managing DAPT during the perioperative period have been proposed. This review presents 3 commonly encountered clinical scenarios that lead into an evidence-based discussion of practical strategies for managing perioperative antiplatelet therapy in patients following percutaneous coronary intervention. Published by Elsevier on behalf of the American College of Cardiology Foundation.

引用

页码：1861 / 1870

页数：10

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