[Perioperative therapy with antiplatelet agents]

Area of Science:

• Cardiology
• Vascular Medicine
• Pharmacology

Background:

• Antiplatelet therapy is vital for preventing blood clots in atherosclerotic disease.
• Clinical decisions require balancing bleeding risks against thromboembolic event risks when stopping therapy.
• Premature cessation can lead to recurrent thromboembolic events, particularly in patients with intracoronary stents.

Purpose of the Study:

• To highlight the critical balance between perioperative bleeding and thromboembolic risks associated with antiplatelet therapy.
• To emphasize the importance of appropriate timing for antiplatelet therapy cessation.
• To underscore the heightened risk of thromboembolic events following premature interruption of dual antiplatelet therapy in patients with intracoronary stents.

Main Methods:

• Review of clinical guidelines and evidence regarding antiplatelet therapy management.
• Analysis of risk factors for perioperative bleeding and thromboembolic complications.
• Case study considerations for patients undergoing procedures requiring temporary discontinuation of antiplatelet agents.

Main Results:

• Discontinuation of antiplatelet therapy necessitates a careful risk-benefit assessment.
• Inadequate cessation timing can precipitate thromboembolic events.
• Patients with intracoronary stents face significantly increased risk if dual antiplatelet therapy is interrupted before stent endothelialization.

Conclusions:

• Optimal management of antiplatelet therapy requires individualized risk assessment.
• Adherence to recommended timelines for therapy interruption and resumption is critical.
• Protecting patients with intracoronary stents from premature dual antiplatelet therapy cessation is paramount to prevent stent thrombosis and other thromboembolic complications.