Consensus Document on Perioperative Antithrombotic Management: Part 1. A Review
10.3904/kjm.2022.97.3.150
- Author:
Yongwhi PARK
1
,
2
;
Ae-Young HER
;
Hyun Kuk KIM
;
Jae Youn MOON
;
Jae Hyoung PARK
;
Keun-Ho PARK
;
Kyung Hoon LEE
;
Hyung Joon JOO
;
Ho Yeon WON
;
Sung Gyun AHN
;
Hong Jun PARK
;
Sung-Jin HONG
;
Beom Joon KIM
;
Seung Pil BAN
;
Jung-Won SUH
;
Young Bin SONG
;
Jung Rae CHO
;
Young-Hoon JEONG
;
Weon KIM
;
Eun-Seok SHIN
;
Author Information
1. Division of Cardiology, Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon
2. Korea
- Publication Type:15
- From:Korean Journal of Medicine
2022;97(3):150-163
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
The prevalence of ischemic heart disease is steadily growing as populations age. Antithrombotic treatment is a key therapeutic modality for the prevention of secondary cerebro-cardiovascular disease. Patients with acute coronary syndrome or who are undergoing percutaneous coronary intervention must be treated with dual antiplatelet therapy for a mandatory period. The optimal perioperative antithrombotic regimen remains debatable; antithrombotics can cause bleeding. Inadequate antithrombotic regimens are associated with perioperative ischemic events, but continuation of therapy may increase the risks of perioperative hemorrhagic complications (including mortality). Many guidelines on the perioperative management of antithrombotic agents have been established by academic societies. However, the existing guidelines do not cover all specialties, nor do they describe the thrombotic and hemorrhagic risks associated with various surgical interventions. Moreover, few practical recommendations on the modification of antithrombotic regimens in patients who require non-deferrable interventions/surgeries or procedures associated with a high risk of hemorrhage have appeared. Therefore, cardiologists, specialists performing invasive procedures, surgeons, dentists, and anesthesiologists have not come to a consensus on optimal perioperative antithrombotic regimens. The Korean Platelet-Thrombosis Research Group presented a positioning paper on perioperative antithrombotic management. We here discuss commonly encountered clinical scenarios and engage in evidence-based discussion to assist individualized, perioperative antithrombotic management in clinical practice.
