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Toward an integrated risk paradigm: personalizing antithrombotic therapy for coronary heart disease with

Ai-Lian Dong1, Xi Chen1, Yuan-Ting Qu1

  • 1Department of Gastroenterology, Hongqi Hospital Affiliated to Mudanjiang Medical University, Mudanjiang, China.

Frontiers in Cardiovascular Medicine
|April 30, 2026
PubMed

Insights

Managing antithrombotic therapy for coronary artery disease requires integrating ischemic and bleeding risks. A new risk-integration paradigm offers a systematic approach for better long-term patient outcomes.

Area of Science:

  • Cardiology
  • Pharmacology
  • Clinical Medicine

Background:

  • Antithrombotic therapy in coronary artery disease (CAD) faces a critical challenge balancing ischemic event prevention with bleeding risk.
  • Current management strategies often address these risks as competing priorities, resulting in suboptimal and reactive treatment plans.

Purpose of the Study:

  • To propose a paradigm shift in antithrombotic therapy management for CAD.
  • To advocate for a risk-integration framework that views ischemic and bleeding risks as interconnected.

Main Methods:

  • This perspective article outlines a conceptual framework for risk integration.
  • Key components include continuous risk assessment, mechanism-based therapeutic selection, phased management strategies, and shared decision-making between clinician and patient.

Main Results:

  • The proposed risk-integration paradigm moves beyond treating risks as competing priorities.
  • It reframes ischemic and bleeding risks as dynamic, interconnected elements of a patient's overall profile.

Conclusions:

  • A systematic and individualized approach to antithrombotic therapy in CAD is achievable through risk integration.
  • This paradigm shift aims to optimize long-term clinical outcomes by holistically managing patient risks.

Keywords:
antiplatelet therapyantithrombotic therapycoronary artery diseasegastrointestinal bleedingmultimorbiditypersonalized medicinerisk integration

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