My patient under dual antiplatelet therapy has to undergo surgery: what to do?

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Cédric Hermans, Catherine Lambert Published in the journal : October 2017 Category : XXVe Journée de Cardiologie

Summary :

An increasing number of patients benefit from a dual antiplatelet therapy combining a low dose of acetylsalicylic acid and a platelet adenosine diphosphate (ADP) receptor antagonist (Clopidogrel, Prasugrel, Ticagrelor), generally indicated in presence of a coronary artery stent and/or a history of acute coronary syndrome. During invasive procedures (operations, biopsies, punctures, dental care, etc.) carried out electively or urgently, the management of this antiplatelet association is often problematic. It must weigh the thrombotic risks following their cessation against the hemorrhagic risks associated with their continuation. This brief article summarizes the practical strategies for managing antiplatelet associations during invasive procedures.

What is already known about the topic?

An increasing number of patients benefit from a dual antiplatelet therapy. During invasive procedures, the management of these antithrombotic agents often proves complex and problematic.

What does this article bring up for us?

After briefly reviewing the properties of various antiplatelet agents, this article summarizes the practical strategies to manage properly antiplatelet therapy in these settings.

Key Words

Antiplatelet agents, invasive procedures, dual therapy, acetylsalycilic acid, Clopidogrel, Prasugrel, Ticagrelor