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Management of antiplatelet therapy among patients on antiplatelet therapy for cerebrovascular or peripheral vascular diseases undergoing elective non-cardiac surgery / principal investigator, Paul Shekelle; co-investigators, Melinda Maggard-Gibbons, Isomi M Miake-Lye, Christopher P Childers, Sean M O'Neill ; contributing investigators, Selene Mak, Roberta Shanman, Jessica M Beroes.
- Format:
- Book
- Government document
- Author/Creator:
- Shekelle, Paul G., author.
- Series:
- Evidence-based synthesis program (Series)
- Evidence-based synthesis program
- Language:
- English
- Subjects (All):
- Cerebrovascular disease--Treatment--United States.
- Cerebrovascular disease.
- Peripheral vascular diseases--Treatment--United States.
- Peripheral vascular diseases.
- Blood platelets--Aggregation.
- Blood platelets.
- Blood--Coagulation--United States.
- Blood.
- Surgery, Elective--United States.
- Surgery, Elective.
- Platelet Aggregation Inhibitors--adverse effects.
- Perioperative Period.
- Elective Surgical Procedures.
- Stents.
- Cerebrovascular Disorders--drug therapy.
- Peripheral Vascular Diseases--drug therapy.
- Blood--Coagulation.
- Cerebrovascular disease--Treatment.
- Peripheral vascular diseases--Treatment.
- United States.
- Medical Subjects:
- Platelet Aggregation Inhibitors--adverse effects.
- Perioperative Period.
- Elective Surgical Procedures.
- Stents.
- Cerebrovascular Disorders--drug therapy.
- Peripheral Vascular Diseases--drug therapy.
- Physical Description:
- 1 online resource (iii, 27 pages) : illustrations.
- Other Title:
- At head of title: QUERI
- Place of Publication:
- Washington, DC : Department of Veterans Affairs, Veterans Health Administration, Quality Enhancement Research Initiative, Health Services Research & Development Service, 2017.
- Summary:
- The perioperative management of antiplatelet therapy (APT) for patients with coronary, cerebrovascular, or peripheral vascular stents remains unclear. After percutaneous coronary intervention, American College of Cardiology (ACC) and American Heart Association (AHA) guidelines recommend delaying elective non-cardiac surgery, ideally 6 months following drug-eluting stent placement and 30 days after bare metal stent placement. For patients on dual antiplatelet therapy (DAPT), ACC/AHA guidelines recommend continuing at least aspirin (ASA) throughout the perioperative period and restarting the P2Y12 inhibitor as soon as possible following surgery. However, this latter recommendation is based on expert opinion and was the focus of a recent ESP report. The conclusion of this report was that studies evaluating APT therapy in patients with coronary stents had significant methodologic limitations and that APT therapy likely has a small impact on perioperative bleeding and major adverse cardiac event (MACE) outcomes, compared to other clinical factors such as operative urgency and timing since stent implantation.
- Notes:
- "October 2017."
- Includes bibliographical references.
- Description based on online resource; title from PDF cover (VA, viewed December 22, 2020).
- OCLC:
- 1033780773
- Access Restriction:
- Access restricted to subscribing institutions.
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