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Cited by 26Antiplatelet Therapy and Cardiovascular DiseasesCoronary Interventions and DiagnosticsAcute Myocardial Infarction Research

Expanding the Recognition and Assessment of Bleeding Events Associated With Antiplatelet Therapy in Primary Care

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Cohen, Marc·2009·Mayo Clinic Proceedings
DOI 10.4065/84.2.149PMC PMC2664586
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Abstract

Antiplatelet therapy is an evidence-based, guideline-recommended, worldwide standard of care for treatment of patients with atherothrombosis. However, clinical implementation of the guidelines is suboptimal, in part because of physician and patient nonadherence. The increased risk of bleeding associated with antiplatelet therapy is often the reason for nonadherence, and several programs have been created to increase adherence to guideline treatment recommendations. Despite the relative success of such initiatives, including Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes With Early Implementation of the ACC/AHA Guidelines, Guidelines Applied in Practice, and the American Heart Association's Get With the Guidelines and a Science Advisory, a current estimate is that less than 50% of atherothrombotic patients are taking antiplatelet therapies as recommended by national guidelines. A PubMed and MEDLINE search of the literature (January 1, 1983-May 15, 2008) was performed to examine the bleeding risks associated with various antiplatelet therapies. Relevant clinical trials, observational registry data, and other studies relevant to treatment and guideline recommendations were selected from articles generated through specific search terms. This comprehensive review contributes to the understanding of the benefit-to-risk ratio of antiplatelet therapy for patients with atherothrombosis.

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  • Antiplatelet agents reduce cardiovascular events and mortality, but their wider use is limited by increased bleeding risk and nonadherence.

    “Use of antiplatelet agents has become a cornerstone for the treatment of CVD because of substantial reduction in CVD events and mortality37,38. However, more widespread use of antiplatelet agents has been limited by the increased risk of bleeding, which also leads to nonadherence39–41.”

    From Development of a gut microbe–targeted nonlethal therapeutic to inhibit thrombosis potential (2018) · cites this paper as [41]

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Authors
Cohen, M.
Affiliations
Newark Beth Israel Medical Center (US)
Corresponding author
Cohen, Marc
ORCID
Cohen, Marc
Venue
Mayo Clinic Proceedings
Publisher
Elsevier BV
Published
2009-02
Volume
84
Issue
2
Pages
149-160
ISSN
0025-6196 (ISSN-L)
DOI
10.4065/84.2.149
PMC
PMC2664586
OpenAlex
W2132064399
Cited by
25
References
87
Citations by year
2025: 2 · 2023: 3 · 2020: 2 · 2019: 1 · 2018: 2 · 2017: 3 · 2016: 1 · 2015: 2 · 2013: 3 · 2012: 1
FWCI
0.30
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Mayo Clinic Proceedings (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Antiplatelet Therapy and Cardiovascular Diseases
  • Health Sciences › Medicine › Surgery › Coronary Interventions and Diagnostics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
Keywords
antiplatelet therapy, bleeding risk, atherothrombosis, guideline adherence, primary care, risk-benefit assessment, guideline implementation, non-compliance, unstable angina, Get With The Guidelines
MeSH terms
Cardiovascular Diseases, Clinical Trials as Topic, Drug Interactions, Hemorrhage, Humans, Practice Patterns, Physicians', Platelet Aggregation Inhibitors, Primary Health Care, Risk Factors, Severity of Illness Index, Survival Analysis, Risk Assessment, Atherosclerosis, Medication Adherence

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