alexa Management of Antiplatelet Therapy in Patients With Coronary Artery Disease Requiring Cardiac and Noncardiac Surgery
Medicine

Medicine

Journal of General Practice

Author(s): Davide Capodanno, Dominick J Angiolillo

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The American College of Cardiology/American Heart Association and American College of Chest Physicians guidelines emphasize the importance of adopting preventive strategies aimed at reducing the risk of premature DAPT discontinuation in stented patients undergoing surgery.28,41 This can be accomplished by avoiding DES implantation whenever possible, especially in patients who are likely to require invasive or surgical procedures within the next 12 months, and by delaying elective procedures for which there is significant risk of perioperative or postoperative bleeding. Strategies aimed at bridging patients on DAPT to their surgical procedure may benefit from the introduction into clinical practice of short-acting intravenous antiplatelet agents with a fast offset of action such as cangrelor. Clinical guidelines also recommend a greater effort by healthcare professionals before patient discharge to ensure proper education about the significant risks associated with prematurely discontinuing DAPT therapy. Similarly, healthcare providers who perform invasive or surgical procedures and who are concerned about periprocedural and postprocedural bleeding must be made aware of the potentially catastrophic risks of premature discontinuation of antiplatelet therapy. When issues regarding DAPT therapy arise, particularly in stented patients, cardiology consultation is indicated.

This article was published in CONTEMPORARY REVIEWS IN CARDIOVASCULAR MEDICINE and referenced in Journal of General Practice

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