Abstract
Antiplatelet is the cornerstone therapy for patient with coronary artery disease. Several comorbidities can influence the efficacy and safety of antiplatelet agent. Diabetes mellitus is characterized by increased platelet reactivity and reduced response to antiplatelet. Elderly patients have both reduced response to antiplatelet and increased risk of bleeding. Patients with renal dysfunction also had decreased efficacy of antiplatelet accompanied with increased risk of bleeding. In patients with atrial fibrillation, the concomitant use of anticoagulant with antiplatelet poses an increased risk of bleeding. In patients with these comorbidities, caution should be stressed in selecting the best regimen of antiplatelet which translates the most optimal efficacy while minimizing the risk of adverse events. In this review, we will discuss the platelet changes in these comorbidities, current evidence of antiplatelet usage in these group of patients and current recommendation.
Keywords: Antiplatelet, coronary artery disease, diabetes mellitus, elderly, renal dysfunction, atrial fibrillation.
Current Pharmaceutical Design
Title:Antiplatelet for Coronary Artery Disease in Specific Condition “No Size Fits All”
Volume: 24 Issue: 4
Author(s): Benny M. Setiadi, Beny Hartono, Adhitia B. Prakoso, Anggia C. Lubis, Reza M. Munandar and Muhammad Munawar*
Affiliation:
- Binawaluya Cardiac Center, Jakarta,Indonesia
Keywords: Antiplatelet, coronary artery disease, diabetes mellitus, elderly, renal dysfunction, atrial fibrillation.
Abstract: Antiplatelet is the cornerstone therapy for patient with coronary artery disease. Several comorbidities can influence the efficacy and safety of antiplatelet agent. Diabetes mellitus is characterized by increased platelet reactivity and reduced response to antiplatelet. Elderly patients have both reduced response to antiplatelet and increased risk of bleeding. Patients with renal dysfunction also had decreased efficacy of antiplatelet accompanied with increased risk of bleeding. In patients with atrial fibrillation, the concomitant use of anticoagulant with antiplatelet poses an increased risk of bleeding. In patients with these comorbidities, caution should be stressed in selecting the best regimen of antiplatelet which translates the most optimal efficacy while minimizing the risk of adverse events. In this review, we will discuss the platelet changes in these comorbidities, current evidence of antiplatelet usage in these group of patients and current recommendation.
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Cite this article as:
Setiadi M. Benny, Hartono Beny , Prakoso B. Adhitia , Lubis C. Anggia , Munandar M. Reza and Munawar Muhammad *, Antiplatelet for Coronary Artery Disease in Specific Condition “No Size Fits All”, Current Pharmaceutical Design 2018; 24 (4) . https://dx.doi.org/10.2174/1381612824666180209111212
DOI https://dx.doi.org/10.2174/1381612824666180209111212 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
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