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Title: | Aspirin-free strategies in cardiovascular disease and cardioembolic stroke prevention | Authors: | Capodanno, Davide Mehran, Roxana Valgimigli, Marco Baber, Usman Windecker, Stephan VRANCKX, Pascal Dangas, George Rollini, Fabiana Kimura, Takeshi Collet, Jean-Philippe Gibson, C. Michael Steg, Philippe Gabriel Lopes, Renato D. Gwon, Hyeon-Cheol Storey, Robert F. Franchi, Francesco Bhatt, Deepak L. Serruys, Patrick W. Angiolillo, Dominick J. |
Issue Date: | 2018 | Publisher: | NATURE PUBLISHING GROUP | Source: | NATURE REVIEWS CARDIOLOGY, 15(8), p. 480-496 | Abstract: | In patients with manifestations of cardiovascular disease, acetylsalicylic acid ( popularly known as aspirin) has been the mainstay of treatment for decades owing to its capacity to reduce the risk of ischaemic events. Accordingly, novel antithrombotic therapies have been traditionally tested on a background of acetylsalicylic acid therapy. Although the adjunctive use of such antithrombotic therapies can potentially further reduce the risk of ischaemic events, these agents are also inevitably associated with an increased risk of bleeding. However, acetylsalicylic acid also increases the risk of bleeding, challenging the paradigm that this agent should remain the cornerstone of antiplatelet treatment when alternative antithrombotic agents are also used. Many antithrombotic compounds are characterized by increased potency and consistent efficacy, which might lessen the need for concomitant acetylsalicylic acid. Accordingly, numerous investigations are testing the hypothesis that acetylsalicylic acid-sparing regimens based on newer antithrombotic agents might have an increased net benefit for individual patients owing to the reduction in bleeding risk, without a trade-off in efficacy. This Review summarizes the state of the art relating to antithrombotic approaches with and without acetylsalicylic acid for the prevention of cardiovascular disease and cardioembolic stroke. Discussion of the scientific rationale, from bench to bedside, for ongoing studies of acetylsalicylic acid-free pharmacological strategies is included. | Notes: | [Capodanno, Davide] Azienda Osped Univ, Cardiothorac Vasc & Transplant Dept, Policlin Vittorio Emanuele, Catania, Italy. [Mehran, Roxana; Baber, Usman; Dangas, George] Icahn Sch Med Mt Sinai, Cardiovasc Inst, New York, NY 10029 USA. [Valgimigli, Marco; Windecker, Stephan] Bern Univ Hosp, Dept Cardiol, Bern, Switzerland. [Vranckx, Pascal] Univ Hasselt, Dept Cardiol & Crit Care Med, Fac Med & Life Sci, Hasselt, Belgium. [Rollini, Fabiana; Franchi, Francesco; Angiolillo, Dominick J.] Univ Florida, Coll Med, Jacksonville, FL 32209 USA. [Kimura, Takeshi] Natl Hosp Org, Asahikawa Med Ctr, Dept Neurol, Asahikawa, Hokkaido, Japan. [Collet, Jean-Philippe] Sorbonne Univ, Inst Cardiol, Hop Pitie Salpetriere, Paris, France. [Collet, Jean-Philippe] Sorbonne Univ, Act Coeur Study Grp, Hop Pitie Salpetriere, Paris, France. [Gibson, C. Michael] Beth Israel Deaconess Med Ctr, Dept Med, Boston, MA 02215 USA. [Steg, Philippe Gabriel] Hop Bichat Claude Bernard, AP HP, Dept Hosp Univ FIRE, Paris, France. [Lopes, Renato D.] Duke Clin Res Inst, Durham, NC USA. [Gwon, Hyeon-Cheol] Heart Vasc Stroke Inst, Dept Internal Med, Seoul, South Korea. [Storey, Robert F.] Univ Sheffield, Dept Infect Immun & Cardiovasc Dis, Sheffield, S Yorkshire, England. [Bhatt, Deepak L.] Brigham & Womens Hosp, Dept Med, Heart & Vasc Ctr, 75 Francis St, Boston, MA 02115 USA. [Serruys, Patrick W.] Imperial Coll Healthcare NHS Trust, London, England. | Document URI: | http://hdl.handle.net/1942/27412 | ISSN: | 1759-5002 | e-ISSN: | 1759-5010 | DOI: | 10.1038/s41569-018-0049-1 | ISI #: | 000438790100012 | Category: | A1 | Type: | Journal Contribution | Validations: | ecoom 2019 |
Appears in Collections: | Research publications |
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capodanno2018.pdf Restricted Access | Published version | 3.65 MB | Adobe PDF | View/Open Request a copy |
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