Abstract
Dual antiplatelet therapy (DAPT) with acetylsalicylic acid and a P2Y12 inhibitor (clopidogrel, ticagrelor, or prasugrel) reduces thrombotic events in patients with acute coronary syndrome (ACS), but it is also associated with an increased risk of bleeding complications. Excessive bleeding in cardiac surgery patients is associated with increased morbidity and mortality and high costs. In this review, different aspects of platelet inhibition in cardiac surgery patients will be discussed, including direct effects on bleeding and transfusion requirements, discontinuation and reinstitution of antiplatelet drugs before and after surgery, and the use of perioperative platelet function testing.
Keywords:
Platelets; bleeding; cardiac surgery; platelet inhibition.
MeSH terms
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Aspirin / administration & dosage
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Aspirin / adverse effects*
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Blood Loss, Surgical* / mortality
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Blood Transfusion
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Cardiac Surgical Procedures / adverse effects*
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Cardiac Surgical Procedures / mortality
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Drug Administration Schedule
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Drug Therapy, Combination
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Humans
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Perioperative Care
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Platelet Aggregation Inhibitors / administration & dosage
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Platelet Aggregation Inhibitors / adverse effects*
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Platelet Function Tests
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Postoperative Hemorrhage / blood
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Postoperative Hemorrhage / chemically induced*
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Postoperative Hemorrhage / mortality
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Postoperative Hemorrhage / prevention & control
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Predictive Value of Tests
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Purinergic P2Y Receptor Antagonists / administration & dosage
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Purinergic P2Y Receptor Antagonists / adverse effects*
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Risk Assessment
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Risk Factors
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Treatment Outcome
Substances
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Platelet Aggregation Inhibitors
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Purinergic P2Y Receptor Antagonists
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Aspirin