Consensus Document of the Italian Association of Hospital Cardiologists (ANMCO), Italian Society of Cardiology (SIC), Italian Association of Interventional Cardiology (SICI-GISE) and Italian Society of Cardiac Surgery (SICCH): clinical approach to pharmacologic pre-treatment for patients undergoing myocardial revascularization procedures

被引:1
作者
Caporale, Roberto [1 ]
Geraci, Giovanna [2 ]
Gulizia, Michele Massimo [3 ]
Borzi, Mauro [4 ]
Colivicchi, Furio [5 ]
Menozzi, A. [6 ]
Musumeci, Giuseppe [7 ]
Scherillo, Marino [8 ]
Ledda, Antonietta [2 ]
Tarantini, Giuseppe [9 ]
Gerometta, Piersilvio [10 ]
Casolo, Giancarlo [11 ]
Formigli, Dario [8 ]
Romeo, Francesco [4 ]
Di Bartolomeo, Roberto [12 ]
机构
[1] Osped Civile Annunziata, Intervent Cardiol Dept, Via Migliori 1, I-87100 Cosenza, Italy
[2] Azienda Osped Riuniti Villa Sofia Cervello, Cardiol Dept, Palermo, Italy
[3] Azienda Rilievo Nazl & Alta Specializzaz Garibald, Osped Garibaldi Nesima, Cardiol Dept, Catania, Italy
[4] Univ Tor Vergata, Cardiol & Intervent Cardiol Dept, Rome, Italy
[5] Osped San Filippo Neri, Dept Cardiol, Rome, Italy
[6] Azienda Osped Univ, Cardiol Unit, Parma, Italy
[7] Osped Santa Croce & Carle, Cardiol Dept, Cuneo, Italy
[8] AOG Rummo, Intervent Cardiol, Benevento, Italy
[9] Univ Padua, Cardiol Sci Thorac & Vasc Dept, Padua, Italy
[10] Ist Humanitas Gavazzeni, Heart Surg Dept, Bergamo, Italy
[11] Nuovo Osped Versilia, Cardiol Dept, Lido Di Camaiore, Lucca, Italy
[12] Osped Policlin S Orsola Malpighi, Heart Surg Unit, Bologna, Italy
关键词
Acute coronary syndromes; Coronary artery disease; Myocardial revascularization; Antiplatelet agents; Anticoagulant agents; Haemorrhage; PERCUTANEOUS CORONARY INTERVENTION; GLYCOPROTEIN IIB/IIIA INHIBITORS; BRIDGING ANTIPLATELET THERAPY; BYPASS GRAFT-SURGERY; LONG-TERM SURVIVAL; UNFRACTIONATED HEPARIN; HIGH-RISK; PLATELET INHIBITION; CLOPIDOGREL PRETREATMENT; UNSTABLE ANGINA;
D O I
10.1093/eurheartj/sux010
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The wide availability of effective drugs in reducing cardiovascular events together with the use of myocardial revascularization has greatly improved the prognosis of patients with coronary artery disease. The combination of antithrombotic drugs to be administered before the knowledge of the coronary anatomy and before the consequent therapeutic strategies, can allow to anticipate optimal treatment, but can also expose the patients at risk of bleeding that, especially in acute coronary syndromes, can significantly weigh on their prognosis, even more than the expected theoretical benefit. In non ST-elevation acute coronary syndromes patients in particular, we propose a 'selective pre-treatment' with P2Y(12) inhibitors, based on the ischaemic risk, on the bleeding risk and on the time scheduled for the execution of coronary angiography. Much of the problems concerning this issue would be resolved by an early access to coronary angiography, particularly for patients at higher ischaemic and bleeding risk.
引用
收藏
页码:D151 / D162
页数:12
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