Role of oral anticoagulant therapy for secondary prevention in patients with stable atherothrombotic disease manifestations.
Sung Won ChoFrancesco FranchiDominick J AngiolilloPublished in: Therapeutic advances in hematology (2019)
Coronary artery disease and peripheral arterial disease are strong predictors of risk for a future ischemic event. Despite the utilization of effective secondary prevention strategies, the prevalence of ischemic recurrences remains high, underscoring the need for effective secondary prevention antithrombotic treatment regimens. To date, most of the tested approaches have been with the use of antiplatelet therapies, used either individually or in combination. However, most recent findings support the potential role of oral anticoagulant therapy in addition to antiplatelet therapy to reduce the risk of ischemic recurrences. This approach has been tested in both acute and stable settings of patients with cardiovascular disease manifestations. The present manuscript provides an overview on the rationale and clinical trial updates on the role of oral anticoagulant therapy, in particular rivaroxaban used at the so-called vascular protection dose, in adjunct to antiplatelet therapy (i.e. aspirin), a strategy known as dual pathway inhibition, for secondary prevention of ischemic recurrences in patients with stable atherosclerotic disease manifestations.
Keyphrases
- antiplatelet therapy
- percutaneous coronary intervention
- atrial fibrillation
- acute coronary syndrome
- coronary artery disease
- venous thromboembolism
- clinical trial
- cardiovascular disease
- ischemia reperfusion injury
- coronary artery bypass grafting
- cerebral ischemia
- low dose
- heart failure
- randomized controlled trial
- type diabetes
- cardiovascular events
- stem cells
- bone marrow
- liver failure
- study protocol
- oxidative stress
- metabolic syndrome
- transcatheter aortic valve replacement
- risk assessment
- current status
- aortic valve
- extracorporeal membrane oxygenation
- aortic dissection
- human health