Peri-operative management of antiplatelet therapy in patients with coronary artery disease

作者：Marco Cattaneo, Pierre‐Guy Chassot, Sabine Eichinger, Christian von Heymann, Niklaus Hofmann, Hans Rickli, Michael Spannagl, Bernhard Ziegler, Freek W.A. Verheugt, Kurt Huber, Wolfgang Korte · 发表于：Thrombosis and Haemostasis · 年份：2011 · DOI：10.1160/th10-04-0217 · 被引用次数：197 · 研究领域：Antiplatelet Therapy and Cardiovascular Diseases、Coronary Interventions and Diagnostics、Cardiac, Anesthesia and Surgical Outcomes

An increasing number of patients suffering from cardiovascular disease, especially coronary artery disease (CAD), are treated with aspirin and/or clopidogrel for the prevention of major adverse events. Unfortunately, there are no specific, widely accepted recommendations for the perioperative management of patients receiving antiplatelet therapy. Therefore, members of the Perioperative Haemostasis Group of the Society on Thrombosis and Haemostasis Research (GTH), the Perioperative Coagulation Group of the Austrian Society for Anesthesiology, Reanimation and Intensive Care (ÖGARI) and the Working Group Thrombosis of the European Society of Cardiology (ESC) have created this consensus position paper to provide clear recommendations on the perioperative use of anti-platelet agents (specifically with semi-urgent and urgent surgery), strongly supporting a multidisciplinary approach to optimize the treatment of individual patients with coronary artery disease who need major cardiac and non-cardiac surgery. With planned surgery, drug eluting stents (DES) should not be used unless surgery can be delayed for ≥12 months after DES implantation. If surgery cannot be delayed, surgical revascularisation, bare-metal stents or pure balloon angioplasty should be considered. During ongoing antiplatelet therapy, elective surgery should be delayed for the recommended duration of treatment. In patients with semi-urgent surgery, the decision to prematurely stop one or both antiplatelet agents (at ...