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La rhumatologie interventionnelle est une activité centrale de la pratique rhumatologique. De nombreux patients, du fait de pathologies cardio- ou neuro-vasculaires, prennent des traitements altérant l'agrégation plaquettaire ou la coagulation. Cette population est donc exposée au risque hémorragique d'un geste sous traitement, ou au risque thrombotique en cas d'arrêt de celui-ci. Les recommandations en vigueur en France sont celles publiées par la HAS en 2008 et 2013, reposant principalement sur des avis d'experts plutôt que sur des données scientifiques robustes. Nous avons procédé à une revue de la littérature parue depuis 2013 concernant les risques hémorragiques et thrombotiques en rhumatologie interventionnelle, en reprenant l'équation de recherche utilisée par la HAS en 2013. Une synthèse des recommandations internationales est proposée concernant la prise des antiagrégants plaquettaires et anticoagulants, en fonction des risques hémorragiques et thrombotiques, ainsi que de chacune des localisations de rhumatologie interventionnelle. Si l'interruption du traitement est nécessaire, les modalités en sont précisées ainsi que sa durée. Les particularités de la reprise des traitements sont également détaillées. Les recommandations en vigueur sont parfois discordantes avec les données plus récentes de la littérature. Ceci incite à la création de nouvelles recommandations ciblant la spécialité rhumatologique. Interventional rheumatology has a key role in the practitioner's activity. Many patients suffer from cardiovascular or neurologic diseases which are the reason for the introduction of an antiplatelet or anticoagulant treatment. Thus, they are exposed to a haemorrhagic risk, as well as a thrombosis risk if an interruption is needed. French recommendations were published in 2008 and 2013, and mainly rely on expert's opinions more than evidence-based medicine. We proceeded in a literature review of all datas published since 2013 about those two risks in interventional rheumatology, using the search equation available in the 2013 HAS document. We propose a summary of the international recommendations pertaining to those interventions, detailing for each antiplatelet or anticoagulant treatment how to proceed, in accordance to the various infiltrations realized in common practice. The existing recommendations can be conflicting with the most up-to-date literature. This urges to elaborate new recommendations focusing on the rheumatologic practice. [ABSTRACT FROM AUTHOR]

Copyright of Archives of Cardiovascular Diseases is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Archives of Cardiovascular Diseases Supplements is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Archives of Cardiovascular Diseases Supplements is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revue de Stomatologie & de Chirurgie Maxillo-Faciale is the property of Masson SPA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: The slow progression over decades of coronary atheroma is often compensated for by arterial remodeling and collateral circulation. Coronary artery disease is therefore often asymptomatic. Sudden rupture of unstable atheromatous plaque always leads to endocoronary thrombus formation. The magnitude and the time frame of this endovascular thrombotic process determine the severity of its clinical consequences: no symptoms, exercise angina, unstable angina, acute transmural myocardial infarction, or sudden death. Two amply validated treatments have the potential to decrease both the probability and the severity of plaque rupture: statins and platelet inhibitors, which are both indicated in all cases of coronary disease. The other therapeutic tools – anti-ischemic drugs, ACE inhibitors, angioplasty, and coronary bypass – are widely used in the management of coronary disease, but their indications should be tailored to each individual clinical situation. [Copyright &y& Elsevier]

Abstract: The clinical benefit of the combination of aspirin plus clopidogrel over aspirin alone to prevent recurrent events after acute coronary syndrome is obviously a key step of the past few years in the management of coronary artery disease. The extended benefit of this combination among patients undergoing stent implantation is another key message for clinician. The consistent benefit of the dual oral antiplatelet therapy in all clinical trials is reassuring for clinicians. However, all well designed clinical trials generate new hypothesis and unsolved clinical issues. The loading dose of clopidogrel and whether we should monitor the biological response to clopidogrel in order to improve its clinical benefit are the next clinical challenges for clinicians dealing with acute coronary syndromes. Providing adequate answers to these relevant clinical issues should improve the clinical benefit of clopidogrel. All these important points are discussed in the following manuscript. [Copyright &y& Elsevier]