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Optimizing antithrombotic therapy in patients with coexisting cardiovascular and gastrointestinal disease.
Talasaz, Azita H; Sadeghipour, Parham; Ortega-Paz, Luis; Kakavand, Hessam; Aghakouchakzadeh, Maryam; Beavers, Craig; Fanikos, John; Eikelboom, John W; Siegal, Deborah M; Monreal, Manuel; Jimenez, David; Vaduganathan, Muthiah; Castellucci, Lana A; Cuker, Adam; Barnes, Geoffrey D; Connors, Jean M; Secemsky, Eric A; Van Tassell, Benjamin W; De Caterina, Raffaele; Kurlander, Jacob E; Aminian, Ali; Piazza, Gregory; Goldhaber, Samuel Z; Moores, Lisa; Middeldorp, Saskia; Kirtane, Ajay J; Elkind, Mitchell S V; Angiolillo, Dominick J; Konstantinides, Stavros; Lip, Gregory Y H; Stone, Gregg W; Cushman, Mary; Krumholz, Harlan M; Mehran, Roxana; Bhatt, Deepak L; Bikdeli, Behnood.
Afiliación
  • Talasaz AH; Arnold & Marie Schwartz College of Pharmacy and Health Sciences, Department of Pharmacy Practice, Long Island University, New York, NY, USA.
  • Sadeghipour P; Division of Pharmacy, New York-Presbyterian/Columbia University Irvine Medical Center, New York, NY, USA.
  • Ortega-Paz L; Department of Pharmacotherapy and Outcome Sciences, Virginia Commonwealth University, Richmond, VA, USA.
  • Kakavand H; Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
  • Aghakouchakzadeh M; Division of Cardiology, University of Florida College of Medicine, Jacksonville, FL, USA.
  • Beavers C; Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
  • Fanikos J; Department of Clinical Pharmacy, School of Pharmacy, Iran University of Medical Sciences, Tehran, Iran.
  • Eikelboom JW; Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
  • Siegal DM; University of Kentucky College of Pharmacy, Lexington, KY, USA.
  • Monreal M; Department of Pharmacy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
  • Jimenez D; Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada.
  • Vaduganathan M; Division of Hematology, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
  • Castellucci LA; Department of Internal Medicine, Hospital Universitari Germans Trials i Pujol, Universidad Católica San Antonio de Murcia, Barcelona, Spain.
  • Cuker A; Respiratory Department, Hospital Ramón y Cajal and Medicine Department, Universidad de Alcalá (IRYCIS), Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, ISCIII, Madrid, Spain.
  • Barnes GD; Cardiovascular Medicine Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
  • Connors JM; Department of Medicine, Ottawa Hospital Research Institute at the University of Ottawa, Ottawa, Ontario, Canada.
  • Secemsky EA; Department of Medicine and Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
  • Van Tassell BW; Frankel Cardiovascular Center, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.
  • De Caterina R; Hematology Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
  • Kurlander JE; Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
  • Aminian A; Smith Center for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
  • Piazza G; Penn Cardiovascular Outcomes, Quality, & Evaluative Research Center, Cardiovascular Medicine Division, Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
  • Goldhaber SZ; Department of Pharmacotherapy and Outcome Sciences, Virginia Commonwealth University, Richmond, VA, USA.
  • Moores L; Cardiology Division, Pisa University Hospital, Pisa, Italy.
  • Middeldorp S; Fondazione Villa Serena per la Ricerca, Città Sant'Angelo, Pescara, Italy.
  • Kirtane AJ; Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.
  • Elkind MSV; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA.
  • Angiolillo DJ; VA Ann Arbor Center for Clinical Management Research, Ann Arbor, MI, USA.
  • Konstantinides S; Bariatric and Metabolic Institute, Department of General Surgery, Cleveland Clinic, Cleveland, OH, USA.
  • Lip GYH; Cardiovascular Medicine Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
  • Stone GW; Thrombosis Research Group, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
  • Cushman M; Cardiovascular Medicine Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
  • Krumholz HM; Thrombosis Research Group, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
  • Mehran R; F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
  • Bhatt DL; Department of Internal Medicine, Radboud Institute of Health Sciences (RIHS), Radboud University Medical Center, Nijmegen, Netherlands.
  • Bikdeli B; Cardiovascular Research Foundation, New York, NY, USA.
Nat Rev Cardiol ; 21(8): 574-592, 2024 08.
Article en En | MEDLINE | ID: mdl-38509244
ABSTRACT
Balancing the safety and efficacy of antithrombotic agents in patients with gastrointestinal disorders is challenging because of the potential for interference with the absorption of antithrombotic drugs and for an increased risk of bleeding. In this Review, we address considerations for enteral antithrombotic therapy in patients with cardiovascular disease and gastrointestinal comorbidities. For those with gastrointestinal bleeding (GIB), we summarize a general scheme for risk stratification and clinical evidence on risk reduction approaches, such as limiting the use of concomitant medications that increase the risk of GIB and the potential utility of gastrointestinal protection strategies (such as proton pump inhibitors or histamine type 2 receptor antagonists). Furthermore, we summarize the best available evidence and potential gaps in our knowledge on tailoring antithrombotic therapy in patients with active or recent GIB and in those at high risk of GIB but without active or recent GIB. Finally, we review the recommendations provided by major medical societies, highlighting the crucial role of teamwork and multidisciplinary discussions to customize the antithrombotic regimen in patients with coexisting cardiovascular and gastrointestinal diseases.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedades Cardiovasculares / Fibrinolíticos / Enfermedades Gastrointestinales / Hemorragia Gastrointestinal Límite: Humans Idioma: En Revista: Nat Rev Cardiol Asunto de la revista: CARDIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedades Cardiovasculares / Fibrinolíticos / Enfermedades Gastrointestinales / Hemorragia Gastrointestinal Límite: Humans Idioma: En Revista: Nat Rev Cardiol Asunto de la revista: CARDIOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido