Evolution of antithrombotic therapy in patients undergoing percutaneous coronary intervention: a 40-year journey
Davide Cao1, Rishi Chandiramani1, Mauro Chiarito1,2,3
1Center for Interventional Cardiovascular Research and Clinical Trials, The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, Box 1030, New York, NY 10029-6574, USA.
Insights
Antithrombotic agents are crucial for patients undergoing percutaneous coronary intervention and stent implantation. This review highlights key advancements in antithrombotic pharmacology and future directions in cardiovascular disease management.
Area of Science:
- Cardiology
- Pharmacology
- Interventional Cardiology
Background:
- Percutaneous coronary intervention (PCI) is a widespread therapeutic procedure.
- The efficacy of PCI is significantly influenced by antithrombotic pharmacotherapies.
- Antithrombotic agents are vital for managing patients undergoing coronary stent implantation and preventing cardiovascular events.
Purpose of the Study:
- To provide an overview of significant milestones in antithrombotic pharmacology.
- To examine the evolution of antithrombotic therapies in interventional cardiology.
- To offer insights into current knowledge gaps and future research directions in the field.
Main Methods:
- Literature review of antithrombotic pharmacotherapies.
- Analysis of historical advancements in interventional cardiology.
- Discussion of pathophysiological mechanisms and adverse events related to PCI.
Main Results:
- Significant improvements in antithrombotic drug therapies over the past 40 years.
- Enhanced understanding of coronary artery disease pathophysiology and its impact on treatment.
- Development of advanced drug-eluting stents and procedural techniques.
Conclusions:
- Antithrombotic pharmacotherapy has evolved in parallel with PCI technology.
- Continued research is necessary to address remaining challenges in antithrombotic treatment.
- Future directions include personalized antithrombotic strategies and novel therapeutic agents.
Abstract:
Since its introduction in 1977, percutaneous coronary intervention has become one of the most commonly performed therapeutic procedures worldwide. Such widespread diffusion, however, would have not been possible without a concomitant evolution of the pharmacotherapies associated with this intervention. Antithrombotic agents are fundamental throughout the management of patients undergoing coronary stent implantation, starting from the procedure itself to the long-term prevention of cardiovascular events. The last 40 years of interventional cardiology have seen remarkable improvements in both drug therapies and device technologies, which largely reflected a progressive understanding of the pathophysiological mechanisms of coronary artery disease, as well as procedure- and device-related adverse events. The purpose of this article is to provide an overview of the important milestones in antithrombotic pharmacology that have shaped clinical practice of today while also providing insights into knowledge gaps and future directions.
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