Antithrombotic treatment strategies in patients with established coronary atherosclerotic disease

Author:

Valgimigli Marco12,Aboyans Victor3,Angiolillo Dominick4,Atar Dan5,Capodanno Davide6,Halvorsen Sigrun78,James Stefan9,Jüni Peter10,Kunadian Vijay11,Landi Antonio112,Leonardi Sergio13,Mehran Roxana14,Montalescot Gilles15,Navarese Eliano Pio16,Niebauer Josef17,Oliva Angelo18,Piccolo Raffaele19,Price Susanna20,Storey Robert F21,Völler Heinz22,Vranckx Pascal2324,Windecker Stephan25,Fox Keith A A26

Affiliation:

1. Division of Cardiology, Cardiocentro Ticino Institute , Ente Ospedaliero Cantonale, Via Tesserete 48, 6900 Lugano , Switzerland

2. Department of Biomedical Sciences, University of Italian Switzerland , Lugano, Switzerland

3. Department of Cardiology, Dupuytren University Hospital, and INSERM 1094 & IRD, University of Limoges , 2, Martin Luther King ave, 87042 Limoges , France

4. Division of Cardiology, University of Florida College of Medicine-Jacksonville , 655 West 8th Street, Jacksonville, FL 32209 , USA

5. Department of Cardiology and Institute of Clinical Medicine, Oslo University Hospital Ulleval, University of Oslo , Oslo , Norway

6. Division of Cardiology, Azienda Ospedaliero Universitaria Policlinico ‘G. Rodolico-San Marco’, University of Catania , Via Santa Sofia, 78, Catania 95123 , Italy

7. Institute of Clinical Medicine, University of Oslo , Blindern, PO Box 1078, N-0316, Oslo , Norway

8. Department of Cardiology, Oslo University Hospital Ulleval , Oslo , Norway

9. Department of Medical Sciences, Uppsala Clinical Research Center, Uppsala University , Uppsala 75185 , Sweden

10. Applied Health Research Centre, Li Ka Shing Knowledge Institute of St Michael's Hospital, Department of Medicine and Institute of Health Policy, Management and Evaluation, University of Toronto , Toronto , Canada

11. Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust , Newcastle upon Tyne , UK

12. Department of Biomedical Sciences, University of Italian Switzerland , Lugano , Switzerland

13. University of Pavia and Coronary Care Unit, Fondazione IRCCS Policlinico San Matteo , Pavia , Italy

14. The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai , New York, NY , USA

15. ACTION Group, INSERM UMRS 1166, Institut de Cardiologie, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Sorbonne Université , Paris , France

16. Department of Cardiology and Internal Medicine, Nicolaus Copernicus University , Bydgoszcz , Poland

17. Institute of Sports Medicine, Prevention and Rehabilitation, Paracelsus Medical University Salzburg , 5020 Salzburg , Austria

18. Department of Biomedical Sciences, Humanitas University , 20090 Pieve Emanuele, Milan , Italy

19. Department of Advanced Biomedical Sciences, Division of Cardiology, University of Naples Federico II , Naples , Italy

20. Royal Brompton Hospital, National Heart and Lung Institute, Imperial College , London , UK

21. Cardiovascular Research Unit, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield , Sheffield , UK

22. Department of Rehabilitation Medicine, Faculty of Health Science Brandenburg, University of Potsdam , Potsdam , Germany

23. Department of Cardiology and Critical Care Medicine , Hartcentrum Hasselt, Jessa Ziekenhuis, Hasselt , Belgium

24. Faculty of Medicine and Life Sciences, Hasselt University , Hasselt , Belgium

25. Department of Cardiology, Inselspital, University of Bern , Bern , Switzerland

26. Division of Clinical and Surgical Sciences, Centre for Cardiovascular Science, University of Edinburgh , Edinburgh , UK

Abstract

Abstract Multiple guidelines and consensus papers have addressed the role of antithrombotic strategies in patients with established coronary artery disease (CAD). Since evidence and terminology continue to evolve, the authors undertook a consensus initiative to guide clinicians to select the optimal antithrombotic regimen for each patient. The aim of this document is to provide an update for clinicians on best antithrombotic strategies in patients with established CAD, classifying each treatment option in relation to the number of antithrombotic drugs irrespective of whether the traditional mechanism of action is expected to mainly inhibit platelets or coagulation cascade. With the aim to reach comprehensiveness of available evidence, we systematically reviewed and performed meta-analyses by means of both direct and indirect comparisons to inform the present consensus document.

Funder

Abbott Vascular

AstraZeneca

Biotronik

Biosensors

St Jude Medical

Terumo

The Medicines Company

Publisher

Oxford University Press (OUP)

Subject

Pharmacology (medical),Cardiology and Cardiovascular Medicine

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