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Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
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Antithrombotic treatment in primary percutaneous coronary intervention

Felix Voll1, Constantin Kuna1, Gjin Ndrepepa1

  • 1Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany.

Expert Review of Cardiovascular Therapy
|March 11, 2021
PubMed

Insights

Optimal antithrombotic therapy for ST-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (pPCI) requires balancing bleeding and clotting risks. Early antiplatelet and anticoagulation, followed by tailored long-term treatment, improves outcomes.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Pharmacology

Background:

  • ST-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (pPCI) face elevated risks of adverse cardiovascular events.
  • Guideline-directed antithrombotic therapy effectively reduces these risks, yet improvements are still needed.

Purpose of the Study:

  • To review current data on antithrombotic therapy in STEMI patients undergoing pPCI.
  • To discuss strategies for optimizing antithrombotic treatment in this high-risk population.

Main Methods:

  • Literature review of current data on antithrombotic therapy in STEMI patients undergoing pPCI.

Main Results:

  • Early administration of antiplatelet agents and anticoagulation is crucial for achieving adequate antithrombotic effect during pPCI.
  • Long-term antithrombotic strategies should be individualized based on patient-specific thrombotic and bleeding risks.

Conclusions:

  • Antithrombotic therapy must address both short-term and long-term risks of thrombosis and bleeding in STEMI patients post-pPCI.
  • Tailoring therapy ensures adequate secondary ischemic prevention while minimizing excess bleeding complications.
Abstract

Keywords:
anticoagulation therapyaspirinclopidogrelcoronary artery diseasedual antiplatelet therapypercutaneous coronary interventionprasugrelticagrelor

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