Τίτλος:
Peri-Procedural Platelet Reactivity in Percutaneous Coronary Intervention
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Platelet activation and aggregation play a pivotal role in thrombotic complications occurring during percutaneous coronary intervention (PCI), and peri-PCI anti-platelet therapy represents a standard of care. High platelet reactivity prior to PCI has been correlated with an increased incidence of peri-procedural myonecrosis. Pre-PCI platelet reactivity predicts post-PCI platelet reactivity and has a prognostic impact on subsequent ischaemic and bleeding events, so as the platelet inhibition measured post-PCI. Many anti-platelet treatment strategies, including aspirin, glycoprotein IIb/IIIa inhibitors, P2Y 12 receptor blockers and vorapaxar, are being used in the routine clinical practice to modify platelet reactivity at each stage, e.g. pre-, during and post-PCI. Anti-platelet strategies with a 'stronger and faster' pharmacodynamic effect than clopidogrel have been mostly adopted in patients with acute coronary syndromes. However, several issues regarding the anti-platelet treatment such as benefits/risks of anti-platelet therapy pre-treatment and duration, and definite association between speed and potency of various anti-platelet agents and clinical outcomes remain controversial. We believe that a better understanding of peri-PCI platelet reactivity and its relations to outcomes may lead to the development of more effective and safe treatment strategies. © 2018 Georg Thieme Verlag KG.
Συγγραφείς:
Alexopoulos, D.
Xenogiannis, I.
Vlachakis, P.
Tantry, U.
Gurbel, P.A.
Περιοδικό:
Thrombosis and Haemostasis
Εκδότης:
Georg Thieme Verlag
Λέξεις-κλειδιά:
antithrombocytic agent; antithrombocytic agent, clinical assessment; clinical effectiveness; clinical practice; disease association; human; meta analysis (topic); outcome assessment; patient safety; percutaneous coronary intervention; platelet reactivity; randomized controlled trial (topic); Review; thrombocyte activation; thrombocyte aggregation; thrombocyte function; adverse event; bleeding; blood; clinical decision making; coronary artery disease; coronary artery thrombosis; drug effect; drug resistance; metabolism; risk assessment; risk factor; thrombocyte; treatment outcome, Blood Platelets; Clinical Decision-Making; Coronary Artery Disease; Coronary Thrombosis; Drug Resistance; Hemorrhage; Humans; Percutaneous Coronary Intervention; Platelet Activation; Platelet Aggregation Inhibitors; Risk Assessment; Risk Factors; Treatment Outcome
DOI:
10.1055/s-0038-1649484
