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Review
. 2019 Nov 19;8(11):2016.
doi: 10.3390/jcm8112016.

Antithrombotic Therapy for Percutaneous Cardiovascular Interventions: From Coronary Artery Disease to Structural Heart Interventions

Alessandro Caracciolo  1 , Paolo Mazzone  1 , Giulia Laterra  1 , Victoria Garcia-Ruiz  2 , Alberto Polimeni  3 , Salvatore Galasso  1 , Francesco Saporito  1 , Scipione Carerj  1 , Fabrizio D'Ascenzo  4 , Guillaume Marquis-Gravel  5   6 , Gennaro Giustino  7   8 , Francesco Costa  1
Affiliations
Review

Antithrombotic Therapy for Percutaneous Cardiovascular Interventions: From Coronary Artery Disease to Structural Heart Interventions

Alessandro Caracciolo et al. J Clin Med. .

Abstract

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.

Keywords: antiplatelet; coronary artery disease; dual antiplatelet therapy; structural heart disease.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Antiplatelet and anticoagulant treatment strategies for secondary prevention of ischemic events.
Figure 2
Figure 2
Design of clinical trials exploring aspirin withdrawal after percutaneous coronary intervention.
Figure 3
Figure 3
Design of clinical trials exploring the combination of oral anticoagulants and antiplatelet agents in patients with non-valvular atrial fibrillation undergoing percutaneous coronary intervention.
Figure 4
Figure 4
Clinical studies testing antithrombotic strategies for secondary prevention of percutaneous structural heart interventions. TAVI: transcatheter aortic valve implantation; TMVR: transcatheter mitral valve repair; LAAO: left atrial appendage occlusion; PFO: patent foramen ovale.
See this image and copyright information in PMC

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