The Role of Novel Oral Anticoagulants and Antiplatelet Therapy after Percutaneous Coronary Intervention: Individualizing Therapy to Optimize Outcomes
Korean Circulation Journal
;
: 645-656, 2019.
Article
in English
| WPRIM
| ID: wpr-759466
ABSTRACT
The number of patients undergoing percutaneous coronary intervention (PCI) who mandate additional oral anticoagulant therapy has been increasing. Dual antiplatelet therapy (DAPT) is associated with reduced ischemic events including stent thrombosis, myocardial infarction and stroke following PCI. However, the tradeoff is an increased risk for bleeding while on DAPT. The addition of a novel oral anticoagulant (NOAC) further increases the likelihood of bleeding while on antiplatelet therapy. Thus, the overall risks and benefits for each patient undergoing PCI on NOAC must be assessed and therapy individualized to ensure optimal therapy for each unique situation. Patients on NOAC undergoing PCI should undergo routine assessment with intravascular imaging as the role of high-risk lesion-related features have increased importance prior to determining optimal duration of treatment with DAPT. We review the best practices for the pharmacologic management of patients requiring anticoagulation with NOAC who are treated with PCI and require antiplatelet therapy.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Thrombosis
/
Stents
/
Practice Guidelines as Topic
/
Risk Assessment
/
Stroke
/
Percutaneous Coronary Intervention
/
Hemorrhage
/
Anticoagulants
/
Myocardial Infarction
Type of study:
Etiology study
/
Practice guideline
/
Risk factors
Limits:
Humans
Language:
English
Journal:
Korean Circulation Journal
Year:
2019
Type:
Article
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