Background: The Importance of Blood Thinner Use
Blood thinners are crucial medications often prescribed to patients who’ve undergone percutaneous coronary intervention (PCI), a procedure to open blocked coronary arteries.
These medications help prevent the formation of dangerous blood clots within the stent placed during the procedure.
However, the criteria for long-term prescription of multiple blood thinners has remained unclear, prompting an in-depth study into the matter.
Research Overview: Studying the ESC Guidelines
This research examines the European Society of Cardiology’s (ESC) criteria for long-term prescription of more than one blood thinner post-PCI.
Presented at the Society for Cardiovascular Angiography & Interventions (SCAI) 2023 Scientific Sessions, the study showed that patients with specific characteristics, as proposed by ESC guidelines, are more prone to complications from blood clotting in the coronary arteries.
The Role of ESC Guidelines in Risk Assessment
The latest ESC guidelines for managing patients with Non-ST-segment elevation acute coronary syndrome recommend that patients with high-risk traits such as a history of myocardial infarction, diabetes, chronic kidney disease, or advanced coronary artery disease might benefit from extended treatment with blood thinners post-PCI.
Study Details and Findings
The study analyzed patients with acute or chronic coronary syndrome who underwent PCI at a large tertiary-care center from 2012 to 2019.
The researchers categorized patients into low, medium, and high thrombotic risk groups based on the ESC criteria.
The primary focus was on major adverse cardiovascular events (MACE) at one year, and the secondary endpoints included individual components of the primary endpoint and major bleeding.
Among 11,787 patients in the study, those at moderate and high risk had an increased one-year risk of MACE compared to those at low risk.
This was mainly due to higher rates of all-cause death and myocardial infarction (MI) in the two former groups. Major bleeding was significantly higher in high-risk patients.
Moving Toward Personalized Medicine
Lead author of the study and SCAI President-Elect, Dr. George Dangas, emphasized the need for personalized cardiology care, adjusting treatments based on individual patient risk factors.
Evaluating the ESC guidelines, as done in this study, represents an essential step toward a more personalized tool to identify high-risk patients who would benefit from long-term treatment with more than one blood thinner.
Through this type of research, medical professionals can better understand the right therapeutic interventions for individual patients, improving the outcomes for those who’ve undergone PCI.
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