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New Antithrombotic Drugs in Acute Coronary Syndrome
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Acute Coronary Syndrome, Antiplatelet Therapy, and Bleeding: A Clinical Perspective

1
Division of Cardiology, Fondazione Cardiocentro Ticino, 6900 Lugano, Switzerland
2
Department of Internal Medicine, Hirslanden Klinik St. Anna, 6006 Lucerne, Switzerland
3
Azienda Sanitaria Locale Torino 4, Ospedale di Ciriè, 10073 Ciriè, Italy
4
Department of Biomedical Sciences, University of Italian Switzerland, 6900 Lugano, Switzerland
5
Department of Cardiology, Kantonsspital Luzern, 6000 Lucerne, Switzerland
*
Authors to whom correspondence should be addressed.
Gregorio Tersalvi and Luigi Biasco equally contributed to this manuscript.
J. Clin. Med. 2020, 9(7), 2064; https://doi.org/10.3390/jcm9072064
Received: 16 June 2020 / Revised: 27 June 2020 / Accepted: 29 June 2020 / Published: 1 July 2020
(This article belongs to the Special Issue Antithrombotic Treatment of Acute Coronary Syndrome)
Inhibition of platelet function by means of dual antiplatelet therapy (DAPT) is the cornerstone of treatment of acute coronary syndrome (ACS). While preventing ischemic recurrences, inhibition of platelet function is clearly associated with an increased bleeding risk, a feared complication that may lead to significant morbidity and mortality. Since bleeding risk management is intrinsically associated with therapeutic adjustments undertaken during the whole clinical history of patients with acute coronary syndrome, single decisions taken from the very first day to years of follow-up might be decisive. This review aims at providing a clinically oriented, patient-tailored approach in reducing the risk and manage bleeding complications in ACS patients treated with DAPT. The steps in clinical decision making from the day of ACS to follow-up are analyzed. New treatment strategies to enhance the safety of DAPT are also described. View Full-Text
Keywords: dual antiplatelet therapy; bleeding; acute coronary syndrome; high bleeding risk; clopidogrel; prasugrel; ticagrelor; tailored therapy; P2Y12 inhibition dual antiplatelet therapy; bleeding; acute coronary syndrome; high bleeding risk; clopidogrel; prasugrel; ticagrelor; tailored therapy; P2Y12 inhibition
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Tersalvi, G.; Biasco, L.; Cioffi, G.M.; Pedrazzini, G. Acute Coronary Syndrome, Antiplatelet Therapy, and Bleeding: A Clinical Perspective. J. Clin. Med. 2020, 9, 2064.

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