Management of Patients with Asymptomatic and Symptomatic Carotid Artery Disease
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Management of Patients with Asymptomatic and Symptomatic Carotid Artery Disease : Update on Anti-Thrombotic Therapy. / Pastori, Daniele; Eikelboom, John W; Anand, Sonia S; Patel, Manesh Raman; Tanguay, Jean-Francois; Ricco, Jean-Baptiste; Debus, Eike Sebastian; Mazzolai, Lucia; Bauersachs, Rupert; Verhamme, Peter; Bosch, Jackie; Nikol, Sigrid; Nehler, Mark; Aboyans, Victor; Violi, Francesco.
in: THROMB HAEMOSTASIS, Jahrgang 119, Nr. 4, 04.2019, S. 576-585.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Review › Forschung
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TY - JOUR
T1 - Management of Patients with Asymptomatic and Symptomatic Carotid Artery Disease
T2 - Update on Anti-Thrombotic Therapy
AU - Pastori, Daniele
AU - Eikelboom, John W
AU - Anand, Sonia S
AU - Patel, Manesh Raman
AU - Tanguay, Jean-Francois
AU - Ricco, Jean-Baptiste
AU - Debus, Eike Sebastian
AU - Mazzolai, Lucia
AU - Bauersachs, Rupert
AU - Verhamme, Peter
AU - Bosch, Jackie
AU - Nikol, Sigrid
AU - Nehler, Mark
AU - Aboyans, Victor
AU - Violi, Francesco
N1 - Georg Thieme Verlag KG Stuttgart · New York.
PY - 2019/4
Y1 - 2019/4
N2 - The most common causes of ischaemic stroke are represented by carotid artery atherosclerotic disease (CAAD) and atrial fibrillation. While oral anticoagulants substantially reduce the incidence of thromboembolic stroke (< 1%/year), the rate of ischaemic stroke and other cardiovascular disease events in patients with CAAD remains high, ranging from 8.4 to 18.1 events per 100 patient-years. Similar to any other atherosclerotic disease, anti-thrombotic therapies are proposed for CAAD to reduce stroke and other cardiovascular events. The 2017 European Society of Cardiology (ESC)/European Society for Vascular Surgery (ESVS) guidelines recommend for patients with asymptomatic CAAD ≥60% the use of aspirin 75 to 100 mg once daily or clopidogrel 75 mg once daily at the exception of patient at very high bleeding risk. For patients with symptomatic CAAD ≥50%, the use of aspirin 75 to 100 mg once daily or clopidogrel 75 mg once daily is recommended. New perspectives for anti-thrombotic therapy for the treatment of patients with CAAD come from the novel dual pathway strategy combining a low-dose anticoagulant (i.e. rivaroxaban) and aspirin that may help reduce long-term ischaemic complications in patients with CAAD. This review summarizes current evidence and recommendations for the anti-thrombotic management of patients with symptomatic or asymptomatic CAAD or those undergoing carotid revascularization.
AB - The most common causes of ischaemic stroke are represented by carotid artery atherosclerotic disease (CAAD) and atrial fibrillation. While oral anticoagulants substantially reduce the incidence of thromboembolic stroke (< 1%/year), the rate of ischaemic stroke and other cardiovascular disease events in patients with CAAD remains high, ranging from 8.4 to 18.1 events per 100 patient-years. Similar to any other atherosclerotic disease, anti-thrombotic therapies are proposed for CAAD to reduce stroke and other cardiovascular events. The 2017 European Society of Cardiology (ESC)/European Society for Vascular Surgery (ESVS) guidelines recommend for patients with asymptomatic CAAD ≥60% the use of aspirin 75 to 100 mg once daily or clopidogrel 75 mg once daily at the exception of patient at very high bleeding risk. For patients with symptomatic CAAD ≥50%, the use of aspirin 75 to 100 mg once daily or clopidogrel 75 mg once daily is recommended. New perspectives for anti-thrombotic therapy for the treatment of patients with CAAD come from the novel dual pathway strategy combining a low-dose anticoagulant (i.e. rivaroxaban) and aspirin that may help reduce long-term ischaemic complications in patients with CAAD. This review summarizes current evidence and recommendations for the anti-thrombotic management of patients with symptomatic or asymptomatic CAAD or those undergoing carotid revascularization.
KW - Aged
KW - Anticoagulants/administration & dosage
KW - Aspirin/administration & dosage
KW - Atherosclerosis/diagnosis
KW - Cardiology/methods
KW - Cardiovascular Diseases/complications
KW - Carotid Arteries/pathology
KW - Carotid Artery Diseases/diagnosis
KW - Clopidogrel/therapeutic use
KW - Female
KW - Hemorrhage
KW - Humans
KW - Male
KW - Middle Aged
KW - Myocardial Revascularization
KW - Platelet Aggregation Inhibitors/therapeutic use
KW - Risk
KW - Rivaroxaban/administration & dosage
U2 - 10.1055/s-0039-1678527
DO - 10.1055/s-0039-1678527
M3 - SCORING: Review article
C2 - 30703812
VL - 119
SP - 576
EP - 585
JO - THROMB HAEMOSTASIS
JF - THROMB HAEMOSTASIS
SN - 0340-6245
IS - 4
ER -