Current Antithrombotic Treatments for Cardiovascular Diseases: A Comprehensive Review.
Kristian GalantiMario Di MarinoDavide MansourSabrina TestaDavide RossiClaudio ScolloRoberta MagnanoLaura PezziAlberto D'AllevaDaniele ForlaniPiergiusto VitulliLeonardo PalosciaFabrizio RicciGiulia RendaSabina GallinaMassimo Di MarcoPublished in: Reviews in cardiovascular medicine (2024)
Antithrombotic therapies (ATT) play a pivotal role in the management of cardiovascular diseases, aiming to prevent ischemic events while maintaining a delicate balance with the patient's bleeding risk. Typically, ATT can be classified into antiplatelet and anticoagulant therapies. Their application spans a broad spectrum of cardiovascular conditions, ranging from ischemic heart disease to atrial fibrillation, encompassing venous thromboembolisms and innovative structural interventional cardiology procedures. The global burden of cardiovascular diseases is steadily increasing, often giving rise to overlapping clinical presentations. Accordingly, the adoption of combined pharmacological approaches becomes imperative, potentially disrupting the delicate equilibrium between ischemic and bleeding risk, thus leading to nuanced pharmacotherapeutic pathways. In this context, contemporary investigations strive to identify a convergence point that optimizes the duration of medical therapy while addressing the need for antithrombotic effects, especially in the context of ischemic heart disease. This review aims to comprehensively revisit the main antithrombotic strategies in cardiovascular diseases, with the intention of enhancing a systematic approach which is key for the effective clinical management of these patients. Also, the review will examine the most impactful studies that have established the groundwork for current scientific evidence, with acknowledgement of special populations. Finally, we will cast a gaze into the future of this dynamic and evolving research field, exploring forthcoming perspectives and advancements.
Keyphrases
- atrial fibrillation
- cardiovascular disease
- oral anticoagulants
- left atrial
- catheter ablation
- left atrial appendage
- direct oral anticoagulants
- end stage renal disease
- heart failure
- percutaneous coronary intervention
- newly diagnosed
- cardiovascular events
- healthcare
- ejection fraction
- cardiovascular risk factors
- chronic kidney disease
- ischemia reperfusion injury
- prognostic factors
- peritoneal dialysis
- risk factors
- cardiac surgery
- cerebral ischemia
- acute kidney injury
- patient reported outcomes
- patient reported
- coronary artery disease
- left ventricular
- thoracic surgery