Update on antithrombotic therapy after percutaneous coronary revascularisation

Lancet. 2017 Aug 19;390(10096):810-820. doi: 10.1016/S0140-6736(17)31936-0.

Abstract

For relief of coronary obstruction, percutaneous coronary intervention has become a standard-of-care procedure over the past 40 years. Nonetheless, optimal outcomes after coronary stenting require careful attention to antithrombotic therapy. This review aims to summarise the current available evidence and discusses how to integrate scientific knowledge into clinical decisions. In recent years, improvement and modifications of drugs and devices have changed the field tremendously, and substantially benefitted patient outcomes. The key challenge of how to provide optimal protection against thrombotic events without excessive increases in bleeding risk has remained the same for decades. Alternative strategies with new drugs, both antiplatelet and anticoagulant agents, and new coronary stents will continue the journey to achieve this ultimate goal.

Publication types

  • Review

MeSH terms

  • Acute Coronary Syndrome / drug therapy*
  • Acute Coronary Syndrome / mortality
  • Administration, Oral
  • Coronary Occlusion / mortality
  • Coronary Occlusion / therapy
  • Drug Substitution
  • Drug Therapy, Combination
  • Drug-Eluting Stents
  • Fibrinolytic Agents / therapeutic use*
  • Humans
  • Long-Term Care
  • Patient Selection
  • Percutaneous Coronary Intervention / methods*
  • Percutaneous Coronary Intervention / mortality
  • Platelet Aggregation Inhibitors / therapeutic use
  • Randomized Controlled Trials as Topic

Substances

  • Fibrinolytic Agents
  • Platelet Aggregation Inhibitors