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Balancing thrombosis and bleeding after out-of-hospital cardiac arrest related to acute coronary syndrome: A literature review
- Source :
- Archives of Cardiovascular Diseases. 114:667-679
- Publication Year :
- 2021
- Publisher :
- Elsevier BV, 2021.
-
Abstract
- Summary Balance between thrombosis and bleeding is now well recognized in patients treated for acute coronary syndrome, with impact on short- and long-term prognosis, including survival. Recent data suggest that patients who are resuscitated after out-of-hospital cardiac arrest related to myocardial infarction are at an even higher risk of bleeding and thrombosis than those with uncomplicated acute coronary syndrome. Delayed enteral absorption of medication due to induced hypothermia and systemic inflammation increases thrombosis risk, whereas transfemoral access site, cardiopulmonary resuscitation manoeuvres and mechanical circulatory support devices increase bleeding risk. In addition, post-resuscitation syndrome and renal or hepatic impairment are potential risk factors for both bleeding and thrombotic complications. There are currently no randomized controlled trials comparing various P2Y12 inhibitor and/or anticoagulation strategies in the setting of out-of-hospital cardiac arrest, and current practice is largely derived from management of patients with uncomplicated acute coronary syndrome. The aim of this review is therefore to describe the bleeding and thrombosis risk factors in this specific population, and to review recent data on antithrombotic drugs in this patient subset.
- Subjects :
- Acute coronary syndrome
medicine.medical_specialty
medicine.medical_treatment
Hemorrhage
Systemic inflammation
law.invention
Percutaneous Coronary Intervention
Randomized controlled trial
law
Internal medicine
Antithrombotic
medicine
Humans
Cardiopulmonary resuscitation
Myocardial infarction
Acute Coronary Syndrome
business.industry
Coronary Thrombosis
Thrombosis
General Medicine
medicine.disease
Circulatory system
Cardiology
medicine.symptom
Cardiology and Cardiovascular Medicine
business
Out-of-Hospital Cardiac Arrest
Subjects
Details
- ISSN :
- 18752136
- Volume :
- 114
- Database :
- OpenAIRE
- Journal :
- Archives of Cardiovascular Diseases
- Accession number :
- edsair.doi.dedup.....a161cb4fee652b311cea888c1ddb35ab