Articles de revues : « Antithrombotic strategies »

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Guedeney, Paul, et Jean-Philippe Collet. « Antithrombotic strategies following TAVR ». Sang thrombose vaisseaux 33, n^o 1 (février 2021) : 19–24. http://dx.doi.org/10.1684/stv.2021.1155.

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Hasan, Md Nazmul, Md Abu Siddique, Sajal Krishna Banerjee, Syed Ali Ahsan, AKM Fazlur Rahman, Choudhury Meshkat Ahmed, Mohammad Faisal Ibn Kabir et Md Harisul Hoque. « Antithrombotic Strategies in Perioperative Period ». University Heart Journal 9, n^o 1 (14 juillet 2014) : 47–51. http://dx.doi.org/10.3329/uhj.v9i1.19511.

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Antithrombotic therapy (Warfarin, Aspirin,Clopidogrel etc.) are routinely used in prevention and treatment of various cardiovascular diseases. In patients who are having a surgical or other invasive procedure, interruption of antithrombotic therapy is typically required to minimize the risk for perioperative bleeding. It involves balancing the risk of periprocedural bleeding with continued treatment against the thrombotic risk with suspension of treatment and use of bridging anticoagulation therapy. The need for bridging is driven by patients estimated risk for thromboembolism and the bleeding risk of invasive procedure. Treatment with subcutaneous low-molecular- weight heparin or intravenous unfractionated heparin at a therapeutic dose before and after the procedure recommended as bridging anticoagulation therapy. DOI: http://dx.doi.org/10.3329/uhj.v9i1.19511 University Heart Journal Vol. 9, No. 1, January 2013; 47-51

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Gremmel, Thomas, et Kurt Huber. « Antithrombotic treatment strategies after PCI ». Lancet 395, n^o 10227 (mars 2020) : 865. http://dx.doi.org/10.1016/s0140-6736(20)30028-3.

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De Caterina, Raffaele, et Ugo Limbruno. « Antithrombotic treatment strategies after PCI ». Lancet 395, n^o 10227 (mars 2020) : 865. http://dx.doi.org/10.1016/s0140-6736(20)30029-5.

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Jeong, Young-Hoon, Yong-Lee Kim, Udaya Tantry et Paul A. Gurbel. « Antithrombotic treatment strategies after PCI ». Lancet 395, n^o 10227 (mars 2020) : 866–67. http://dx.doi.org/10.1016/s0140-6736(20)30030-1.

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Romiti, Giulio Francesco, Stefania Basili et Marco Proietti. « Antithrombotic treatment strategies after PCI ». Lancet 395, n^o 10227 (mars 2020) : 866. http://dx.doi.org/10.1016/s0140-6736(20)30031-3.

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Auer, Johann, Robert Berent et Franz Gurtner. « Antithrombotic treatment strategies after PCI ». Lancet 395, n^o 10227 (mars 2020) : 865–66. http://dx.doi.org/10.1016/s0140-6736(20)30032-5.

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Channon, Keith M., et Brian H. Annex. « Antithrombotic strategies in gene therapy ». Current Cardiology Reports 2, n^o 1 (janvier 2000) : 34–38. http://dx.doi.org/10.1007/s11886-000-0023-4.

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Gurbel, Paul A., Palak Shah, Shashank Desai et Udaya S. Tantry. « Antithrombotic Strategies and Device Thrombosis ». Cardiology Clinics 36, n^o 4 (novembre 2018) : 541–50. http://dx.doi.org/10.1016/j.ccl.2018.06.008.

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Shishehbor, Mehdi H., et Barry T. Katzen. « Antithrombotic Strategies in Endovascular Interventions ». Interventional Cardiology Clinics 2, n^o 4 (octobre 2013) : 627–33. http://dx.doi.org/10.1016/j.iccl.2013.06.005.

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Ramachandran, Preeti, Eileen King, Ashley Nebbia, Robert H. Beekman et Jeffrey B. Anderson. « Variability of antithrombotics use in patients with hypoplastic left heart syndrome and its variants following first- and second-stage palliation surgery : a national report using the National Pediatric Cardiology Quality Improvement Collaborative registry ». Cardiology in the Young 27, n^o 4 (30 août 2016) : 731–38. http://dx.doi.org/10.1017/s1047951116001189.

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AbstractPurposePatients with hypoplastic left heart syndrome and its variants following palliation surgery are at risk for thrombosis. This study examines variability of antithrombotic practice, the incidence of interstage shunt thrombosis, and other adverse events following Stage I and Stage II palliation within the National Pediatric Cardiology Quality Improvement Collaborative registry.MethodsWe carried out a multicentre, retrospective review using the National Pediatric Cardiology Quality Improvement Collaborative registry including patients from 2008 to 2013 across 52 surgical sites. Antithrombotic medications used at Stage I and Stage II discharge were evaluated. Variability of antithrombotics use at the individual patient level and intersite variability, incidence of shunt thrombosis, and other adverse events such as cardiac arrest, seizure, stroke, and need for cardiac catheterisation intervention in the interstage period were identified. Antithrombotic strategies for hybrid Stage I patients were evaluated but they were excluded from the variability and outcomes analysis.ResultsA total of 932 Stage I and 923 Stage II patients were included in the study: 93.8% of Stage I patients were discharged on aspirin and 4% were discharged on no antithrombotics, and 77% of Stage II patients were discharged on aspirin and 17.5% were discharged on no antithrombotics. Only three patients (0.2%) presented with interstage shunt thrombosis. The majority of patients who died during interstage or required shunt dilation and/or stenting were discharged home on aspirin.ConclusionAspirin is the most commonly used antithrombotic following Stage I and Stage II palliation. There is more variability in the choice of antithrombotics following Stage II compared with Stage I. The incidence of interstage shunt thrombosis and associated adverse events was rare.

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Prandoni, Paolo. « Antithrombotic Strategies in Patients with Cancer ». Thrombosis and Haemostasis 78, n^o 01 (1997) : 141–44. http://dx.doi.org/10.1055/s-0038-1657517.

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Potsis, Thomas Z., Christos Katsouras et John A. Goudevenos. « Avoiding and Managing Bleeding Complications in Patients with Non-ST-Segment Elevation Acute Coronary Syndromes ». Angiology 60, n^o 2 (28 mai 2008) : 148–58. http://dx.doi.org/10.1177/0003319708317339.

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Antithrombotic therapy coupled with early use of cardiac catheterization and revascularization have decreased morbidity and mortality rates in patients who have acute ischemic heart disease but who carry a risk for bleeding. Bleeding complications in patients with acute coronary syndromes are associated with worse clinical outcomes, including recurrent ischemic events and death. Determining the appropriate balance between preventing ischemic events and causing bleeding in patients with acute coronary syndromes present a challenging problem for clinicians. Antithrombotics studied in recent clinical trials that have focused on bleeding reduction include bivalirudin and fondaparinux. In this review, the incidence, predictors, and clinical outcomes associated with bleeding are discussed. Furthermore, the association between antithrombotic agents and bleeding and propose strategies to prevent bleeding complications are also discussed.

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Tarzia, V., C. Tessari, A. Fabozzo, C. Cavalli, T. Bocca, C. Pagnin, B. Volpe, T. Bottio et G. Gerosa. « RF03 ANTITHROMBOTIC STRATEGIES AFTER HEARTMATE III IMPLANTATION ». Journal of Cardiovascular Medicine 19 (novembre 2018) : e62. http://dx.doi.org/10.2459/01.jcm.0000550036.12636.f0.

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Vranckx, Pascal, Marco Valgimigli, Lars Eckardt, Giuseppe Gargiulo et Andreas Goette. « Antithrombotic treatment strategies after PCI – Authors' reply ». Lancet 395, n^o 10227 (mars 2020) : 867–68. http://dx.doi.org/10.1016/s0140-6736(20)30033-7.

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Harker, Laurence A. « New Antithrombotic Strategies for Resistant Thrombotic Processes ». Journal of Clinical Pharmacology 34, n^o 1 (janvier 1994) : 3–16. http://dx.doi.org/10.1002/j.1552-4604.1994.tb03960.x.

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Selvarajah, Abi, Anne H. Tavenier, Enrico Fabris, Maarten A. H. van Leeuwen et Renicus S. Hermanides. « Current and Future Insights for Optimizing Antithrombotic Therapy to Reduce the Burden of Cardiovascular Ischemic Events in Patients with Acute Coronary Syndrome ». Journal of Clinical Medicine 11, n^o 19 (23 septembre 2022) : 5605. http://dx.doi.org/10.3390/jcm11195605.

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The pharmacological treatment strategies for acute coronary syndrome (ACS) in recent years are constantly evolving to develop more potent antithrombotic agents, as reflected by the introduction of more novel P2Y12 receptor inhibitors and anticoagulants to reduce the ischemic risk among ACS patients. Despite the substantial improvements in the current antithrombotic regimen, a noticeable number of ACS patients continue to experience ischemic events. Providing effective ischemic risk reduction while balancing bleeding risk remains a clinical challenge. This updated review discusses the currently approved and widely used antithrombotic agents and explores newer antithrombotic treatment strategies under development for the initial phase of ACS.

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Connolly, D. L. « ABC of antithrombotic therapy : Antithrombotic strategies in acute coronary syndromes and percutaneous coronary interventions ». BMJ 325, n^o 7377 (14 décembre 2002) : 1404–7. http://dx.doi.org/10.1136/bmj.325.7377.1404.

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Fernández-Ruiz, Irene. « Tailoring antithrombotic strategies for high-risk AF populations ». Nature Reviews Cardiology 16, n^o 6 (1 avril 2019) : 321. http://dx.doi.org/10.1038/s41569-019-0195-0.

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Turpie, A. G. G. « ABC of antithrombotic therapy : Venous thromboembolism : treatment strategies ». BMJ 325, n^o 7370 (26 octobre 2002) : 948–50. http://dx.doi.org/10.1136/bmj.325.7370.948.

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Medi, Caroline, Graeme J. Hankey et Saul B. Freedman. « Stroke Risk and Antithrombotic Strategies in Atrial Fibrillation ». Stroke 41, n^o 11 (novembre 2010) : 2705–13. http://dx.doi.org/10.1161/strokeaha.110.589218.

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Weitz, Jeffrey I., et Noel C. Chan. « Novel antithrombotic strategies for treatment of venous thromboembolism ». Blood 135, n^o 5 (30 janvier 2020) : 351–59. http://dx.doi.org/10.1182/blood.2019000919.

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Abstract Venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolism (PE), is the third most common cause of vascular death after heart attack and stroke. Anticoagulation therapy is the cornerstone of VTE treatment. Despite such therapy, up to 50% of patients with DVT develop postthrombotic syndrome, and up to 4% of patients with PE develop chronic thromboembolic pulmonary hypertension. Therefore, better therapies are needed. Although direct oral anticoagulants are more convenient and safer than warfarin for VTE treatment, bleeding remains the major side effect, particularly in cancer patients. Factor XII and factor XI have emerged as targets for new anticoagulants that may be safer. To reduce the complications of VTE, attenuation of thrombin activatable fibrinolysis inhibitor activity is under investigation in PE patients to enhance endogenous fibrinolysis, whereas blockade of leukocyte interaction with the vessel wall is being studied to reduce the inflammation that contributes to postthrombotic syndrome in DVT patients. Focusing on these novel antithrombotic strategies, this article explains why safer anticoagulants are needed, provides the rationale for factor XII and XI as targets for such agents, reviews the data on the factor XII– and factor XI–directed anticoagulants under development, describes novel therapies to enhance fibrinolysis and decrease inflammation in PE and DVT patients, respectively, and offers insights into the opportunities for these novel VTE therapies.

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Potti, Anil, Christopher P. Rusconi, Bruce A. Sullenger et Thomas L. Ortel. « Regulatable aptamers in medicine : focus on antithrombotic strategies ». Expert Opinion on Biological Therapy 4, n^o 10 (octobre 2004) : 1641–47. http://dx.doi.org/10.1517/14712598.4.10.1641.

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Assadian, A., C. Senekowitsch, O. Assadian, U. Eidher, G. W. Hagmüller et P. Knöbl. « Antithrombotic Strategies in Vascular Surgery : Evidence and Practice ». European Journal of Vascular and Endovascular Surgery 29, n^o 5 (mai 2005) : 516–21. http://dx.doi.org/10.1016/j.ejvs.2005.01.021.

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Ranasinghe, Mark, Karlheinz Peter et James McFadyen. « Thromboembolic and Bleeding Complications in Transcatheter Aortic Valve Implantation : Insights on Mechanisms, Prophylaxis and Therapy ». Journal of Clinical Medicine 8, n^o 2 (25 février 2019) : 280. http://dx.doi.org/10.3390/jcm8020280.

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Transcatheter aortic valve implantation (TAVI) has emerged as an important alternative to surgical aortic valve repair (SAVR) for patients with severe aortic stenosis. This rapidly advancing field has produced new-generation devices being delivered with small delivery sheaths, embolic protection devices and improved retrieval features. Despite efforts to reduce the rate of thrombotic complications associated with TAVI, valve thrombosis and cerebral ischaemic events post-TAVI continue to be a significant issue. However, the antithrombotic treatments utilised to prevent these dreaded complications are based on weak evidence and are associated with high rates of bleeding, which in itself is associated with adverse clinical outcomes. Recently, experimental data has shed light on the unique mechanisms, particularly the complex haemodynamic changes at sites of TAVI, that underpin the development of post-TAVI thrombosis. These new insights regarding the drivers of TAVI-associated thrombosis, coupled with the ongoing development of novel antithrombotics which do not cause bleeding, hold the potential to deliver newer, safer therapeutic paradigms to prevent post-TAVI thrombotic and bleeding complications. This review highlights the major challenge of post-TAVI thrombosis and bleeding, and the significant issues surrounding current antithrombotic approaches. Moreover, a detailed discussion regarding the mechanisms of post-TAVI thrombosis is provided, in addition to an appraisal of current antithrombotic guidelines, past and ongoing clinical trials, and how novel therapeutics offer the hope of optimizing antithrombotic strategies and ultimately improving patient outcomes.

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Ashcraft, Morgan, Megan Douglass, YuJie Chen et Hitesh Handa. « Combination strategies for antithrombotic biomaterials : an emerging trend towards hemocompatibility ». Biomaterials Science 9, n^o 7 (2021) : 2413–23. http://dx.doi.org/10.1039/d0bm02154g.

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Chua, Su-Kiat, Lung-Ching Chen, Kou-Gi Shyu, Jun-Jack Cheng, Huei-Fong Hung, Chiung-Zuan Chiu et Chiu-Mei Lin. « Antithrombotic Strategies in Patients with Atrial Fibrillation Following Percutaneous Coronary Intervention : A Systemic Review and Network Meta-Analysis of Randomized Controlled Trials ». Journal of Clinical Medicine 9, n^o 4 (8 avril 2020) : 1062. http://dx.doi.org/10.3390/jcm9041062.

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Up to 10% of patients with atrial fibrillation (AF) undergo percutaneous coronary intervention (PCI). A systematic review and network meta-analysis were conducted by searching PubMed, Embase, and the Cochrane database of systematic reviews for randomized control trials that studied the safety and efficacy of different antithrombotic strategies in these patients. Six studies, including 12,158 patients were included. Compared to that in the triple antithrombotic therapy group (vitamin K antagonist (VKA) plus P2Y12 inhibitor and aspirin), thrombolysis in myocardial infarction (TIMI) major bleeding was significantly reduced in the dual antithrombotic therapy (non-vitamin K oral anticoagulants (NOACs) plus P2Y12 inhibitor) group by 47% (Odds ratio (OR), 0.53; 95% credible interval [CrI], 0.35–0.78; I2 = 0%). Besides, NOAC plus a P2Y12 inhibitor was associated with less intracranial hemorrhage compared to VKA plus single antiplatelet therapy (OR: 0.20, 95% CrI: 0.05–0.77). There was no significant difference in the trial-defined major adverse cardiac events or the individual outcomes of all-cause mortality, cardiovascular death, myocardial infarction, stroke or stent thrombosis among all antithrombotic strategies. In conclusion, antithrombotic strategy of NOACs plus P2Y12 inhibitor is safer than, and as effective as, the strategies including aspirin when used in AF patients undergoing PCI.

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Jung, Da Hyun, et Jun Chul Park. « Strategies that Reduce Post-endoscopic Submucosal Dissection Bleeding ». Korean Journal of Helicobacter and Upper Gastrointestinal Research 21, n^o 3 (10 septembre 2021) : 194–202. http://dx.doi.org/10.7704/kjhugr.2021.0028.

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Bleeding after endoscopic submucosal dissection (ESD), one of the most common postprocedural adverse events, is the main cause of increased readmission rates and hospital costs. Generally, the incidence of post-ESD bleeding is estimated to be about 5%. However, the incidence of bleeding is particularly increased in high-risk patients. In particular, it has an incidence of over 50% in patients that use antithrombotic agents. The well-known risk factors for post-ESD bleeding include antithrombotic therapy, lesions in the proximal stomach, specimen size >4 cm, and concomitant renal disease. Currently, the number of patients at a high risk of post-ESD bleeding has been increasing. This may be due to the aging society and the increase in the usage of antithrombotic agents. Therefore, several strategies have been employed to prevent post-ESD bleeding. These strategies include acid inhibition therapy, preventive hemostasis using Doppler endoscopic ultrasound and artery-selective clipping, second look endoscopy, the closings method, and the shield methods. However, these methods are technically demanding, which hinders their wide usage in clinical practice. Recently, several hemostatic powders have been developed and clinically used in the treatment of gastrointestinal bleeding. In this article, we review the risk factors for post-ESD bleeding and the recently introduced prevention methods. Moreover, we aimed to explore realistic and appropriate strategies for the prevention of post-ESD bleeding.

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Capodanno, Davide, et Dominick J. Angiolillo. « Antithrombotic Therapy for Atherosclerotic Cardiovascular Disease Risk Mitigation in Patients With Coronary Artery Disease and Diabetes Mellitus ». Circulation 142, n^o 22 (décembre 2020) : 2172–88. http://dx.doi.org/10.1161/circulationaha.120.045465.

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Patients with diabetes mellitus (DM) are characterized by enhanced thrombotic risk attributed to multiple mechanisms including hyperreactive platelets, hypercoagulable status, and endothelial dysfunction. As such, they are more prone to atherosclerotic cardiovascular events than patients without DM, both before and after coronary artery disease (CAD) is established. In patients with DM without established CAD, primary prevention with aspirin is not routinely advocated because of its increased risk of major bleeding that largely offsets its ischemic benefit. In patients with DM with established CAD, secondary prevention with antiplatelet drugs is an asset of pharmacological strategies aimed at reducing the risk of atherosclerotic cardiovascular events and their adverse prognostic consequences. Such antithrombotic strategies include single antiplatelet therapy (eg, with aspirin or a P2Y 12 inhibitor), dual antiplatelet therapy (eg, aspirin combined with a P2Y 12 inhibitor), and dual-pathway inhibition (eg, aspirin combined with the vascular dose of the direct oral anticoagulant rivaroxaban) for patients with chronic ischemic heart disease, acute coronary syndromes, and those undergoing percutaneous coronary intervention. Because of their increased risk of thrombotic complications, patients with DM commonly achieve enhanced absolute benefit from more potent antithrombotic approaches compared with those without DM, which most often occurs at the expense of increased bleeding. Nevertheless, studies have shown that when excluding individuals at high risk for bleeding, the net clinical benefit favors the use of intensified long-term antithrombotic therapy in patients with DM and CAD. Several studies are ongoing to establish the role of novel antithrombotic strategies and drug formulations in maximizing the net benefit of antithrombotic therapy for patients with DM. The scope of this review article is to provide an overview of current and evolving antithrombotic strategies for primary and secondary prevention of atherosclerotic cardiovascular events in patients with CAD and DM.

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Calcaterra, Ilenia, Pasquale Ambrosino, Nicoletta Vitelli, Roberta Lupoli, Roberta Clara Orsini, Martina Chiurazzi, Mauro Maniscalco et Matteo Nicola Dario Di Minno. « Risk Assessment and Antithrombotic Strategies in Antiphospholipid Antibody Carriers ». Biomedicines 9, n^o 2 (27 janvier 2021) : 122. http://dx.doi.org/10.3390/biomedicines9020122.

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Antiphospholipid antibodies (aPL) are a cluster of autoantibodies directed against plasma proteins with affinity for membrane phospholipids. The most frequently tested aPL are lupus anticoagulant (LA), anti-cardiolipin antibodies (aCL), and anti-β2-glycoprotein I antibodies (anti-β2GPI). aPL play a key pathogenic role in the development of the antiphospholipid syndrome (APS), a systemic autoimmune disease characterized by recurrent thrombotic and/or pregnancy complications in patients with persistent aPL. However, aPL positivity is occasionally documented in patients with no previous history of thrombotic or pregnancy morbidity. LA activity, multiple aPL positivity, high-titer aPL, and a concomitant systemic autoimmune disease are recognized risk factors for future thrombotic events in asymptomatic carriers. Moreover, an accelerated atherosclerosis with increased cardiovascular (CV) risk has also been associated with aPL positivity, thus exposing aPL carriers to fatal complications and chronic disability requiring cardiac rehabilitation. Overall, an accurate risk stratification is recommended for aPL-positive subjects in order to prevent both venous and arterial thrombotic complications. In this review, we provide an overview of the main antithrombotic and risk assessment strategies in aPL carriers.

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Dillinger, Jean-Guillaume, Marc Laine, Sara Bouajila, Franck Paganelli, Patrick Henry et Laurent Bonello. « Antithrombotic strategies in elderly patients with acute coronary syndrome ». Archives of Cardiovascular Diseases 114, n^o 3 (mars 2021) : 232–45. http://dx.doi.org/10.1016/j.acvd.2020.12.002.

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Roel, Valentin, Juan Moukarzel, Ezequiel Zaidel, Matìas Galli, Walter Da Rosa, Rodolfo Leiva, Carolina Cicero et Jorge Thierer. « Antithrombotic Strategies in Atrial Fibrillation. The XIX CONAREC Registry ». Revista Argentina de Cardiología 83, n^o 3 (juillet 2015) : 208–14. http://dx.doi.org/10.7775/rac.v83.i3.5723.

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Chen, Gordon L., Chunming Dong et Pascal J. Goldschmidt-Clermont. « Journey in Antithrombotic Strategies for ST-Elevation Myocardial Infarction ». Critical Pathways in Cardiology : A Journal of Evidence-Based Medicine 9, n^o 4 (décembre 2010) : 235–42. http://dx.doi.org/10.1097/hpc.0b013e31820303ff.

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Nahab, F., T. Kass-Hout et H. M. Shaltoni. « Periprocedural antithrombotic strategies in acute ischemic stroke interventional therapy ». Neurology 79, Issue 13, Supplement 1 (24 septembre 2012) : S174—S181. http://dx.doi.org/10.1212/wnl.0b013e31826959af.

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BATES, BETSY. « New ACCP Guidelines Update Strategies for Antithrombotic/Thrombolytic Therapy ». Caring for the Ages 9, n^o 11 (novembre 2008) : 9. http://dx.doi.org/10.1016/s1526-4114(08)60301-7.

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Capodanno, Davide, et Corrado Tamburino. « Antithrombotic Strategies in Valvular and Structural Heart Disease Interventions ». Interventional Cardiology Clinics 2, n^o 4 (octobre 2013) : 635–42. http://dx.doi.org/10.1016/j.iccl.2013.05.005.

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Tatterton, Mark, Stacy-Paul Wilshaw, Eileen Ingham et Shervanthi Homer-Vanniasinkam. « The Use of Antithrombotic Therapies in Reducing Synthetic Small-Diameter Vascular Graft Thrombosis ». Vascular and Endovascular Surgery 46, n^o 3 (5 février 2012) : 212–22. http://dx.doi.org/10.1177/1538574411433299.

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Background. Thrombosis of synthetic small-diameter bypass grafts remains a major problem. The aim of this article is to review the antithrombotic strategies that have been used in an attempt to reduce graft thrombogenicity. Methods. A PubMed/MEDLINE search was performed using the search terms “vascular graft thrombosis,” “small-diameter graft thrombosis,” “synthetic graft thrombosis” combined with “antithrombotic,” “antiplatelet,” “anticoagulant,” “Dacron,” “PTFE,” and “polyurethane.” Results. The majority of studies on antithrombotic therapies have used either in vitro models or in vivo animal experiments. Many of the therapies used in these settings do show antithrombotic efficacy against synthetic graft materials. There is however, a distinct lack of human in vivo studies to further delineate the performance and limitations of therapies displaying good antithrombotic characteristics. Conclusion. Very few antithrombotic therapies have translated into clinical use. More human in vivo studies are required to assess the efficacy and safety of such therapies.

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Bäuml, Marina, et Ingo Hilgendorf. « Future Antithrombotic Therapies in Cardiology ». Hämostaseologie 38, n^o 04 (28 septembre 2018) : 236–39. http://dx.doi.org/10.1055/s-0038-1670653.

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AbstractThrombi are composed of activated platelets and fibrin, the latter being the final product of the blood coagulation system. Therefore, antithrombotic therapies may either interfere with adhesion, aggregation, secretion or signalling of platelets or with fibrin formation. Established drugs potently inhibit clot formation, but also increase the risk of bleeding. In this review article, we discuss novel strategies for the inhibition of pathological thrombosis while enabling normal haemostasis, thus minimizing the risk of bleeding.

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Vogiatzi, Georgia, Antonios Pantazis et Dimitris Tousoulis. « Antithrombotic Treatment in Cardiomyopathies ». Current Pharmaceutical Design 26, n^o 23 (14 juillet 2020) : 2762–68. http://dx.doi.org/10.2174/1381612826666200429230726.

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: Cardiomyopathies are a heterogeneous group of heart muscle diseases and important cause of heart failure with reduced or preserved ejection fraction. Although there is an increasing body of evidence on the incidence, pathophysiology, and natural history of heart failure (HF) in cardiomyopathies, certain aspects of the therapeutic strategies remain unclear. More particularly, there is no consensus if to whether antithrombotic therapy has a favorable risk: benefit ratio in reducing thromboembolic event rate in patients with cardiomyopathies without suffering from primary valvular disease or atrial fibrillation. Although the observational data on increased venous thromboembolic risk are supported by multiple pathophysiological mechanisms, the role of antithrombotic therapy in these patients remains unclear. This review article provides an overview of epidemiologic, pathophysiologic, clinical, and therapeutic data for the prevention of thromboembolism in heart failure due to cardiomyopathies.

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Hernández Vera, Rodrigo, Teresa Padró, Gemma Vilahur et Lina Badimon. « Antithrombotic therapy in obesity ». Thrombosis and Haemostasis 110, n^o 10 (2013) : 681–88. http://dx.doi.org/10.1160/th12-12-0928.

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summaryClinical management of obese subjects to reduce their risk of suffering cardiovascular events is complex. Obese patients typically require preventive strategies, life-style modifications, and multi-drug therapy to address obesity-induced co-morbidities. Data regarding the effects of excess weight on the pharmacokinetics of most drugs is scarce as these individuals are often excluded from clinical trials. However, the physiological alterations observed in obese patients and their lower response to some antiplatelet agents and anticoagulants have suggested that dosage regimes need to be adjusted for these subjects. In this review we will briefly discuss platelet alterations that can contributeto increased thrombotic risk, analyse existing data regarding the effects of obesity on drug pharmacokinetics focusing on antiplatelet agents and anticoagulants, and we will describe the beneficial effects of weight loss on thrombosis.

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Lapina, N. S., A. A. Alekseeva, A. D. Vershinina, N. S. Khruleva, F. N. Muradova et L. Y. Koroleva. « Gastrointestinal Bleeding in Antithrombotic Therapy in Patients with Coronary Heart Disease : Risk Factors, Pathogenesis and Treatment ». Russian Journal of Gastroenterology, Hepatology, Coloproctology 30, n^o 3 (7 juillet 2020) : 14–23. http://dx.doi.org/10.22416/1382-4376-2020-30-3-14-23.

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Aim. Description of risk factors, pathogenesis and treatment strategies of gastrointestinal bleeding (GIB) in the course of antithrombotic therapy in patients with coronary heart disease (CHD).Key points. Risk factors of GIB during antithrombotic therapy in CHD patients include: GIB, gastric and/or duodenal ulcer in the history, reflux esophagitis, presence of H. pylori, inflammatory bowel disease, diverticula, haemorrhoids, angiodysplasia, gastrointestinal neoplasia, age above 65 years, concomitant treatment with non-steroidal anti-inflammatory drugs (NSAIDs), glomerular filtration rate <50 mL/min, high doses of direct oral anticoagulants (DOACs) ≥3 in HAS-BLED score. Pathogenesis of GIB in the course of antithrombotic therapy is associated with systemic hypocoagulation and local damaging effects of these drugs. Strategies of GIB treatment during DOAC therapy in patients with CHD are determined by severity of bleeding and threat to life. Aside to standard conservative measures, endoscopic or surgical haemostasis requires usage of antidotes to suppress effects of DOACs and other specific drugs in severe cases.Conclusion. GIB associated with antithrombotic therapy in CHD patients poses a serious medical problem of growing importance with wider application of anticoagulant drugs. Antithrombotic therapy requires accurate decision making, risk assessment, careful monitoring of the patient’s condition and timely diagnosis of gastrointestinal disorders following good rationale in GIB prevention.

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Park, Yongwhi, Ae-Young Her, Hyun Kuk Kim, Jae Youn Moon, Jae Hyoung Park, Keun-Ho Park, Kyung Hoon Lee et al. « Consensus Document on Perioperative Antithrombotic Management : Part 2. Case Study ». Korean Journal of Medicine 97, n^o 4 (1 août 2022) : 204–28. http://dx.doi.org/10.3904/kjm.2022.97.4.204.

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Given the progressive improvements in antithrombotic strategies, management of cardiovascular disease has become sophisticated/refined. However, the optimal perioperative management of antithrombotic therapy in patients with acute coronary syndrome or who are scheduled for percutaneous coronary intervention remains unclear. Assessments of the thrombotic and hemorrhagic risks are essential to reduce the rates of mortality and major cardiac events. However, the existing guidelines do not mention these topics. This case-based consensus document deals with common clinical scenarios and offers evidence-based guidelines for individualized perioperative management of antithrombotic therapy in the real world.

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Caracciolo, Alessandro, Paolo Mazzone, Giulia Laterra, Victoria Garcia-Ruiz, Alberto Polimeni, Salvatore Galasso, Francesco Saporito et al. « Antithrombotic Therapy for Percutaneous Cardiovascular Interventions : From Coronary Artery Disease to Structural Heart Interventions ». Journal of Clinical Medicine 8, n^o 11 (19 novembre 2019) : 2016. http://dx.doi.org/10.3390/jcm8112016.

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Percutaneous cardiovascular interventions have changed dramatically in recent years, and the impetus given by the rapid implementation of novel techniques and devices have been mirrored by a refinement of antithrombotic strategies for secondary prevention, which have been supported by a significant burden of evidence from clinical studies. In the current manuscript, we aim to provide a comprehensive, yet pragmatic, revision of the current available evidence regarding antithrombotic strategies in the domain of percutaneous cardiovascular interventions. We revise the evidence regarding antithrombotic therapy for secondary prevention in coronary artery disease and stent implantation, the complex interrelation between antiplatelet and anticoagulant therapy in patients undergoing percutaneous coronary intervention with concomitant atrial fibrillation, and finally focus on the novel developments in the secondary prevention after structural heart disease intervention. A special focus on treatment individualization is included to emphasize risk and benefits of each therapeutic strategy.

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Shirokov, Evgeniy A., N. V. Lomakin et L. I. Buryachkovskaya. « A critical analysis of antithrombotic strategy in the acute period of ischemic stroke ». Clinical Medicine (Russian Journal) 96, n^o 9 (30 décembre 2018) : 773–83. http://dx.doi.org/10.18821/0023-2149-2018-96-9-773-783.

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The article is a critical review of the current literature on the issue of antithrombotic therapy in the acute phase of ischemic stroke. Despite the overall pathogenesis today, there are significant differences in the antithrombotic strategy used in acute coronary syndrome and ischemic stroke. Although reperfusion therapy is the most effective method of treatment of patients with thrombotic occlusion of the arteries of the heart or brain, only about 5% of neurological patients receive intravenous thrombolysis tissue plasminogen activator. In emergency neurology unused opportunities of platelet antiplatelet agents last generations, not appointed anticoagulants. The article examines issues of interdisciplinary collaboration and perspectives of modern antithrombotic strategies in neurology from the point of view of the neurologist, cardiologist and expert on antithrombotic therapy.

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Romiti, Giulio Francesco. « New Paradigms in Antithrombotic Strategies : A Leap into the Future of Cardiovascular Medicine ». Journal of Clinical Medicine 11, n^o 10 (10 mai 2022) : 2693. http://dx.doi.org/10.3390/jcm11102693.

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Bae, Jae S., Jong-Hwa Ahn, Udaya S. Tantry, Paul A. Gurbel et Young-Hoon Jeong. « Should Antithrombotic Treatment Strategies in East Asians Differ from Caucasians ? » Current Vascular Pharmacology 16, n^o 5 (10 juillet 2018) : 459–76. http://dx.doi.org/10.2174/1570161116666180117103238.

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Kucherenko, S. S., et T. M. Alekseeva. « Modern strategies of antithrombotic therapy in patients with multifocal atherosclerosis ». Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova 122, n^o 2 (2022) : 49. http://dx.doi.org/10.17116/jnevro202212202149.

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Harker, Laurence A., Stephen R. Hanson et Andrew B. Kelly. « Antithrombotic Strategies Targeting Thrombin Activities, Thrombin Receptors and Thrombin Generation ». Thrombosis and Haemostasis 78, n^o 01 (1997) : 736–41. http://dx.doi.org/10.1055/s-0038-1657621.

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Chen, Shaojie, Felix K. Weise, K. R. Julian Chun et Boris Schmidt. « Antithrombotic strategies after interventional left atrial appendage closure : an update ». Expert Review of Cardiovascular Therapy 16, n^o 9 (29 août 2018) : 675–78. http://dx.doi.org/10.1080/14779072.2018.1510316.

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Nixdorff, Uwe. « Antithrombotic strategies for the management of non-valvular atrial fibrillation ». International Journal of Cardiology 100, n^o 2 (avril 2005) : 191–98. http://dx.doi.org/10.1016/j.ijcard.2004.12.030.

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