Current percutaneous coronary intervention guidelines recommend dual antiplatelets(aspirin 100 mg + clopidogrel 75 mg daily) for at least 12 mo following drugeluting stent(DES) implantation if patients are not at high...Current percutaneous coronary intervention guidelines recommend dual antiplatelets(aspirin 100 mg + clopidogrel 75 mg daily) for at least 12 mo following drugeluting stent(DES) implantation if patients are not at high risk of bleeding.Several reports have tried to shorten the dual antiplatelet therapy to 3-6 mo,especially following next-generation DES implantation,for cost-effectiveness.However,the clinical results are inconsistent and the data regarding next-generation DESs limited.In this report,recently published important pivotal reports regarding the optimal duration of dual antiplatelets following DES implantation are summarized.展开更多
Nowadays,elderly people represent a growing population segment with a well known increased risk of both ischemic and bleeding events.Current acute coronary syndrome guidelines,strongly recommend dual antiplatelet ther...Nowadays,elderly people represent a growing population segment with a well known increased risk of both ischemic and bleeding events.Current acute coronary syndrome guidelines,strongly recommend dual antiplatelet therapy(DAPT)with few specific references for aged patients due to lack of evidence.Patients aged>75 years are misrepresented in the classic derivation trials cohorts.Strategies to reduce the bleeding risk in this group of patients are urgently needed for the daily clinical practice.Identify the specific age related bleeding risk factors and the importance of an integral geriatric assessment remains challenging.Some of the available in-hospital and out-hospital bleeding risk scores have shown a lower to moderate predictive ability in older patients and no specific tools are developed in elderly population.The importance of an appropriate vascular access choice,type and duration of antiplatelet drugs is crucial to reduce the bleeding risk.Increase radial approaches and short DAPT duration leads to reduce hemorrhages.One interesting subgroup of patients is those who need chronic anticoagulation therapy after percutaneous coronary intervention,due to their very high risk of bleeding.New alternatives as dual therapy with oral anticoagulation and only one antiplatlet drug should be considered.In current review,we evaluate the available evidence about bleeding risk in elderly.展开更多
文摘Current percutaneous coronary intervention guidelines recommend dual antiplatelets(aspirin 100 mg + clopidogrel 75 mg daily) for at least 12 mo following drugeluting stent(DES) implantation if patients are not at high risk of bleeding.Several reports have tried to shorten the dual antiplatelet therapy to 3-6 mo,especially following next-generation DES implantation,for cost-effectiveness.However,the clinical results are inconsistent and the data regarding next-generation DESs limited.In this report,recently published important pivotal reports regarding the optimal duration of dual antiplatelets following DES implantation are summarized.
文摘Nowadays,elderly people represent a growing population segment with a well known increased risk of both ischemic and bleeding events.Current acute coronary syndrome guidelines,strongly recommend dual antiplatelet therapy(DAPT)with few specific references for aged patients due to lack of evidence.Patients aged>75 years are misrepresented in the classic derivation trials cohorts.Strategies to reduce the bleeding risk in this group of patients are urgently needed for the daily clinical practice.Identify the specific age related bleeding risk factors and the importance of an integral geriatric assessment remains challenging.Some of the available in-hospital and out-hospital bleeding risk scores have shown a lower to moderate predictive ability in older patients and no specific tools are developed in elderly population.The importance of an appropriate vascular access choice,type and duration of antiplatelet drugs is crucial to reduce the bleeding risk.Increase radial approaches and short DAPT duration leads to reduce hemorrhages.One interesting subgroup of patients is those who need chronic anticoagulation therapy after percutaneous coronary intervention,due to their very high risk of bleeding.New alternatives as dual therapy with oral anticoagulation and only one antiplatlet drug should be considered.In current review,we evaluate the available evidence about bleeding risk in elderly.
