Submit Manuscript  

Article Details


New antithrombotic strategies and coronary stent technologies for patients at high bleeding risk undergoing percutaneous coronary intervention

Author(s):

Sabato Sorrentino*, Nadia Salerno, Isabella Leo, Alberto Polimeni, Jolanda Sabatino, Carmen Anna Maria Spaccarotella, Annalisa Mongiardo, Salvatore De Rosa and Ciro Indolfi  

Abstract:


Patients at high bleeding risk (HBR) are a sizable part of the population undergoing percutaneous coronary intervention (PCI) and stent implantation. This population historically lacks standardized definition, thus limiting trial design, data generalizability, and clinical decision-making. To overcome this limitation the Academic Research Consortium (ARC) has recently released comprehensive guidelines defining HBR criteria for study design purpose and daily clinical practice. Furthermore, several risk scores have been developed aiming to discriminate HBR patients and support physicians for clinical decision making when faced with this complex subset of patients. Accordingly, the first part of this review article will explore guideline-recommended risk scoring as well as ARC-HBR criteria and their relative application for daily clinical practice. The second part of this review article will explore the complex interplay between risk of bleeding, and coronary thrombotic events in patients deemed at HBR. Indeed, several features that identify these patients, are also independent predictors of recurrent ischemic events, thus challenging revascularization strategies and optimal antithrombotic therapy. Accordingly, several clinical trials have been conducted to evaluate the safety and efficacy of the new generation of coronary platforms and different antithrombotic strategies for HBR patients to minimize both ischemic and bleeding events. Accordingly, in this part we discuss current guidelines, trials and observational data evaluating antithrombotic strategies and stent technologies for patients at HBR.

Keywords:

high bleeding risk, antithrombotic therapy, stent, percutaneous coronary intervention

Affiliation:

Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Division of Cardiology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro



Full Text Inquiry