Resumption of Antiplatelet Therapy after Major Bleeding.
Tobias GeislerSven PoliKurt HuberDominik RathParwez AiderySteen D KristensenRobert F StoreyAlex BallJean Philippe ColletJurriën Ten BergPublished in: Thrombosis and haemostasis (2022)
Major bleeding is a common threat in patients requiring antiplatelet therapy. Timing and intensity with regard to resumption of antiplatelet therapy represent a major challenge in clinical practice. Knowledge of the patient's bleeding risk, defining transient/treatable and permanent/untreatable risk factors for bleeding, and weighing these against thrombotic risk are key to successful prevention of major adverse events. Shared decision-making involving various disciplines is essential to determine the optimal strategy. The present article addresses clinically relevant questions focusing on the most life-threatening or frequently occurring bleeding events, such as intracranial hemorrhage and gastrointestinal bleeding, and discusses the evidence for antiplatelet therapy resumption using individual risk assessment in high-risk cardiovascular disease patients.
Keyphrases
- antiplatelet therapy
- acute coronary syndrome
- percutaneous coronary intervention
- atrial fibrillation
- end stage renal disease
- cardiovascular disease
- risk assessment
- chronic kidney disease
- ejection fraction
- coronary artery disease
- clinical practice
- prognostic factors
- type diabetes
- peritoneal dialysis
- patient reported outcomes
- cardiovascular events
- heavy metals
- blood brain barrier
- patient reported
- case report
- optical coherence tomography