Vol 16, No 2 (2009)
How to do
Published online: 2009-01-06
Dual antiplatelet therapy and antithrombotic treatment: Recommendations and controversies
Cardiol J 2009;16(2):179-189.
Abstract
Dual antiplatelet therapy is currently recommended for all patients with acute coronary syndromes,
independent of whether they receive pharmacological treatment or undergo percutaneous
coronary intervention. Antiplatelet agents are the cornerstone of pharmacological treatment
in interventional cardiology. However, there is a clear need for randomized trials to
assess the treatment strategy of dual antiplatelet therapy in patients who also need long-term
antithrombotic treatment (such as those with atrial fibrillation, prosthetic heart valve, mitral
valve regurgitation or stenosis, deep vein thrombosis, pulmonary embolism, or pulmonary
hypertension). In this paper we discuss trials and analyses on the use of dual antiplatelet
treatment in combination with antithrombotic therapy in particular diseases, with a focus on
the risk of hemorrhagic events connected with this treatment, as well as recent guidelines of the
European Society of Cardiology, the American College of Cardiology, and the American Heart
Association.
Keywords: antiplatelet therapyantithrombotic treatmentacetylsalicylic acidclopidogreloral anticoagulantsacute coronary syndromesatrial fibrillation