Management of Patients with Asymptomatic and Symptomatic Carotid Artery Disease: Update on Anti-Thrombotic Therapy.

Details

Serval ID
serval:BIB_FBD9E9821D78
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Management of Patients with Asymptomatic and Symptomatic Carotid Artery Disease: Update on Anti-Thrombotic Therapy.
Journal
Thrombosis and haemostasis
Author(s)
Pastori D., Eikelboom J.W., Anand S.S., Patel M.R., Tanguay J.F., Ricco J.B., Debus E.S., Mazzolai L., Bauersachs R., Verhamme P., Bosch J., Nikol S., Nehler M., Aboyans V., Violi F.
ISSN
2567-689X (Electronic)
ISSN-L
0340-6245
Publication state
Published
Issued date
04/2019
Peer-reviewed
Oui
Volume
119
Number
4
Pages
576-585
Language
english
Notes
Publication types: Journal Article ; Review
Publication Status: ppublish
Abstract
The most common causes of ischaemic stroke are represented by carotid artery atherosclerotic disease (CAAD) and atrial fibrillation. While oral anticoagulants substantially reduce the incidence of thromboembolic stroke (< 1%/year), the rate of ischaemic stroke and other cardiovascular disease events in patients with CAAD remains high, ranging from 8.4 to 18.1 events per 100 patient-years. Similar to any other atherosclerotic disease, anti-thrombotic therapies are proposed for CAAD to reduce stroke and other cardiovascular events. The 2017 European Society of Cardiology (ESC)/European Society for Vascular Surgery (ESVS) guidelines recommend for patients with asymptomatic CAAD ≥60% the use of aspirin 75 to 100 mg once daily or clopidogrel 75 mg once daily at the exception of patient at very high bleeding risk. For patients with symptomatic CAAD ≥50%, the use of aspirin 75 to 100 mg once daily or clopidogrel 75 mg once daily is recommended. New perspectives for anti-thrombotic therapy for the treatment of patients with CAAD come from the novel dual pathway strategy combining a low-dose anticoagulant (i.e. rivaroxaban) and aspirin that may help reduce long-term ischaemic complications in patients with CAAD. This review summarizes current evidence and recommendations for the anti-thrombotic management of patients with symptomatic or asymptomatic CAAD or those undergoing carotid revascularization.
Keywords
Aged, Anticoagulants/administration & dosage, Anticoagulants/therapeutic use, Aspirin/administration & dosage, Atherosclerosis/diagnosis, Atherosclerosis/drug therapy, Atherosclerosis/epidemiology, Cardiology/methods, Cardiovascular Diseases/complications, Carotid Arteries/pathology, Carotid Artery Diseases/diagnosis, Carotid Artery Diseases/drug therapy, Carotid Artery Diseases/epidemiology, Clopidogrel/therapeutic use, Female, Hemorrhage, Humans, Male, Middle Aged, Myocardial Revascularization, Platelet Aggregation Inhibitors/therapeutic use, Risk, Rivaroxaban/administration & dosage
Pubmed
Web of science
Open Access
Yes
Create date
14/02/2019 15:29
Last modification date
24/09/2019 5:11
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