TY - JOUR
T1 - Focused Clinical Review
T2 - Periprocedural Management of Antiplatelet Therapy in Patients with Coronary Stents
AU - Bell, Brendan
AU - Layland, Jamie
AU - Poon, Karl
AU - Spaulding, Christian
AU - Walters, Darren
PY - 2011/7/1
Y1 - 2011/7/1
N2 - Coronary stent implantation, particularly drug eluting stents, is now the major method of coronary revascularisation. Following drug-eluting stent implantation dual antiplatelet therapy with aspirin and thienopyridine is recommended for at least 12 months. Premature discontinuation, often at the time of noncardiac surgery, has been associated with stent thrombosis which has a significant risk of death and myocardial infarction. Late (>30 days) and very late (>365 days) stent thrombosis appears to more common with DES and poses the questions of when is it safe to stop antiplatelet therapy post coronary stenting and how to manage patients who need non-cardiac surgery. This article reviews the evidence for stent thrombosis and the peri-operative management of patients with coronary stents and provides an algorithm for patient management based on multidisciplinary assessment of bleeding risk, perioperative cardiac event and stent thrombosis risk.
AB - Coronary stent implantation, particularly drug eluting stents, is now the major method of coronary revascularisation. Following drug-eluting stent implantation dual antiplatelet therapy with aspirin and thienopyridine is recommended for at least 12 months. Premature discontinuation, often at the time of noncardiac surgery, has been associated with stent thrombosis which has a significant risk of death and myocardial infarction. Late (>30 days) and very late (>365 days) stent thrombosis appears to more common with DES and poses the questions of when is it safe to stop antiplatelet therapy post coronary stenting and how to manage patients who need non-cardiac surgery. This article reviews the evidence for stent thrombosis and the peri-operative management of patients with coronary stents and provides an algorithm for patient management based on multidisciplinary assessment of bleeding risk, perioperative cardiac event and stent thrombosis risk.
KW - Drug-eluting stent
KW - Dual antiplatelet therapy
KW - Stent thrombosis
UR - http://www.scopus.com/inward/record.url?scp=79958696301&partnerID=8YFLogxK
U2 - 10.1016/j.hlc.2011.03.005
DO - 10.1016/j.hlc.2011.03.005
M3 - Review Article
C2 - 21493140
AN - SCOPUS:79958696301
VL - 20
SP - 438
EP - 445
JO - Heart Lung and Circulation
JF - Heart Lung and Circulation
SN - 1443-9506
IS - 7
ER -