수술 및 시술 시 항혈전제 사용에 대한 전문가 합의문: 1부. 종설편
Consensus Document on Perioperative Antithrombotic Management: Part 1. A Review
1
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
The prevalence of ischemic heart disease is steadily growing as populations age. Antithrombotic treatment is a key therapeutic modality for the prevention of secondary cerebro-cardiovascular disease. Patients with acute coronary syndrome or who are undergoing percutaneous coronary intervention must be treated with dual antiplatelet therapy for a mandatory period. The optimal perioperative antithrombotic regimen remains debatable; antithrombotics can cause bleeding. Inadequate antithrombotic regimens are associated with perioperative ischemic events, but continuation of therapy may increase the risks of perioperative hemorrhagic complications (including mortality). Many guidelines on the perioperative management of antithrombotic agents have been established by academic societies. However, the existing guidelines do not cover all specialties, nor do they describe the thrombotic and hemorrhagic risks associated with various surgical interventions. Moreover, few practical recommendations on the modification of antithrombotic regimens in patients who require non-deferrable interventions/surgeries or procedures associated with a high risk of hemorrhage have appeared. Therefore, cardiologists, specialists performing invasive procedures, surgeons, dentists, and anesthesiologists have not come to a consensus on optimal perioperative antithrombotic regimens. The Korean Platelet-Thrombosis Research Group presented a positioning paper on perioperative antithrombotic management. We here discuss commonly encountered clinical scenarios and engage in evidence-based discussion to assist individualized, perioperative antithrombotic management in clinical practice.
Abstract
The prevalence of ischemic heart disease is steadily growing as populations age. Antithrombotic treatment is a key therapeutic modality for the prevention of secondary cerebro-cardiovascular disease. Patients with acute coronary syndrome or who are undergoing percutaneous coronary intervention must be treated with dual antiplatelet therapy for a mandatory period. The optimal perioperative antithrombotic regimen remains debatable; antithrombotics can cause bleeding. Inadequate antithrombotic regimens are associated with perioperative ischemic events, but continuation of therapy may increase the risks of perioperative hemorrhagic complications (including mortality). Many guidelines on the perioperative management of antithrombotic agents have been established by academic societies. However, the existing guidelines do not cover all specialties, nor do they describe the thrombotic and hemorrhagic risks associated with various surgical interventions. Moreover, few practical recommendations on the modification of antithrombotic regimens in patients who require non-deferrable interventions/surgeries or procedures associated with a high risk of hemorrhage have appeared. Therefore, cardiologists, specialists performing invasive procedures, surgeons, dentists, and anesthesiologists have not come to a consensus on optimal perioperative antithrombotic regimens. The Korean Platelet-Thrombosis Research Group presented a positioning paper on perioperative antithrombotic management. We here discuss commonly encountered clinical scenarios and engage in evidence-based discussion to assist individualized, perioperative antithrombotic management in clinical practice.
참고문헌 (47)
- Tokushige A, "Incidence and outcome of surgical procedures after coronary bare-metal and drug-eluting stent implantation: a report from the CREDO-Kyoto PCI", CABG registry cohort-2, 2012, pp.5, 237~246
- Capodanno D, "Management of antiplatelet therapy in patients with coronary artery disease requiring cardiac and noncardiac surgery", Circulation, 128, pp.2785~2798 (2013)
- Biondi-Zoccai GG, "A systematic review and meta-analysis on the hazards of discontinuing or not adhering to aspirin among 50, 279 patients at risk for coronary artery disease", Eur Heart J, 27, pp.2667~2674 (2006)
- Smilowitz NR, "Perioperative acute myocardial infarction associated with non-cardiac surgery", Eur Heart J, 38, pp.2409~2417 (2017)
- Rossini R, "Antiplatelet therapy and outcome in patients undergoing surgery following coronary stenting: Results of the surgery after stenting registry", Catheter Cardiovasc Interv, 89, pp.E13~E25 (2017)
- Egholm G, "Risk associated with surgery within 12 months after coronary drug-eluting stent implantation", J Am Coll Cardiol, 68, pp.2622~2632 (2016)
- Rajagopalan S, "Platelet activation, myocardial ischemic events and postoperative non-response to aspirin in patients undergoing major vascular surgery", J Thromb Haemost, 5, pp.2028~2035 (2007)
- Priebe HJ, "Triggers of perioperative myocardial ischaemia and infarction", Br J Anaesth, 93, pp.9~20 (2004)
- Oprea AD, "Perioperative management of antiplatelet therapy", Br J Anaesth, 111(Suppl 1), pp.i3~i17 (2013)[DOI]
- Rossini R, "A multidisciplinary approach on the perioperative antithrombotic management of patients with coronary stents undergoing surgery: surgery after stenting 2", JACC Cardiovasc Interv, 11, pp.417~434 (2018)
- Stawiarski K, "Dual-antiplatelet therapy guidelines and implications for perioperative management", J Cardiothorac Vasc Anesth, 32, pp.1072~1080 (2018)
- Levine GN, "2016 ACC", AHA guideline focused update on duration of dual antiplatelet therapy in patients with coronary artery disease: a report of the American College of Cardiology, AHA, pp.SCAI guideline for percutaneous coronary intervention, 2011 ACCF, AHA guideline for coronary artery bypass graft surgery, 2012 ACC[DOI]
- Rossini R, "Perioperative management of antiplatelet therapy in patients with coronary stents undergoing cardiac and non-cardiac surgery: a consensus document from Italian cardiological, surgical and anaesthesiological societies", EuroIntervention, 10, pp.38~46 (2014)
- Valgimigli M, "2017 ESC focused update on dual antiplatelet therapy in coronary artery disease developed in collaboration with EACTS: the task force for dual antiplatelet therapy in coronary artery disease of the European Society of Cardiology (ESC) and of the European Association for Cardio-Thoracic Surgery (EACTS)", Eur Heart J, 39, pp.213~260 (2018)
- Hawn MT, "Risk of major adverse cardiac events following noncardiac surgery in patients with coronary stents", JAMA, 310, pp.1462~1472 (2013)
- Devereaux PJ, "Aspirin in patients undergoing noncardiac surgery", N Engl J Med, 370, pp.1494~1503 (2014)
- Graham MM, "Aspirin in patients with previous percutaneous coronary intervention undergoing noncardiac surgery", Ann Intern Med, 168, pp.237~244 (2018)
- Oscarsson A, "To continue or discontinue aspirin in the perioperative period : a randomized, controlled clinical trial", Br J Anaesth, 104, pp.305~312 (2010)
- Rossini R, "Perioperative management of oral antiplatelet therapy and clinical outcomes in coronary stent patients undergoing surgery. Results of a multicentre registry", Thromb Haemost, 113, pp.272~282 (2015)
- Hawn MT, "The incidence and timing of noncardiac surgery after cardiac stent implantation", J Am Coll Surg, 214, pp.658~667 (2012)
- Mehran R, "Cessation of dual antiplatelet treatment and cardiac events after percutaneous coronary intervention (PARIS): 2 year results from a prospective observational study", Lancet, 382, pp.1714~1722 (2013)
- Wilson SH, "Clinical outcome of patients undergoing non-cardiac surgery in the two months following coronary stenting", J Am Coll Cardiol, 42, pp.234~240 (2003)
- Cruden NL, "Previous coronary stent implantation and cardiac events in patients undergoing noncardiac surgery", Circ Cardiovasc Interv, 3, pp.236~242 (2010)
- Burger W, "Low-dose aspirin for secondary cardiovascular prevention -cardiovascular risks after its perioperative withdrawal versus bleeding risks with its continuation - review and meta-analysis", J Intern Med, 257, pp.399~414 (2005)
- Colombo A, "Second-generation drug-eluting stent implantation followed by 6-versus 12-month dual antiplatelet therapy : the SECURITY randomized clinical trial", J Am Coll Cardiol, 64, pp.2086~2097 (2014)
- Gwon HC, "Six-month versus 12-month dual antiplatelet therapy after implantation of drug-eluting stents: the efficacy of xience", promus versus cypher to reduce late loss after stenting (EXCELLENT) randomized, multicenter study, 2012, pp.125, 505~513
- Feres F, "Three vs twelve months of dual antiplatelet therapy after zotarolimus-eluting stents:the OPTIMIZE randomized trial", JAMA, 310, pp.2510~2522 (2013)
- Wijeysundera DN, "Risk of elective major noncardiac surgery after coronary stent insertion : a population-based study", Circulation, 126, pp.1355~1362 (2012)
- Holcomb CN, "The incremental risk of coronary stents on postoperative adverse events : a matched cohort study", Ann Surg, 263, pp.924~930 (2016)
- Giustino G, "Efficacy and safety of dual antiplatelet therapy after complex PCI", J Am Coll Cardiol, 68, pp.1851~1864 (2016)
- Subherwal S, "Baseline risk of major bleeding in non-ST-segment-elevation myocardial infarction:the CRUSADE (can rapid risk stratification of unstable angina patients suppress adverse outcomes with early implementation of the ACC", AHA guidelines) bleeding score, 2009, pp.119, 1873~1882
- Mehran R, "A risk score to predict bleeding in patients with acute coronary syndromes", J Am Coll Cardiol, 55, pp.2556~2566 (2010)
- Pisters R, "A novel user-friendly score (HAS-BLED) to assess 1-year risk of major bleeding in patients with atrial fibrillation: the Euro Heart Survey", Chest, 138, pp.1093~1100 (2010)
- Capodanno D, "Impact of bridging with perioperative low-molecular-weight heparin on cardiac and bleeding outcomes of stented patients undergoing non-cardiac surgery", Thromb Haemost, 114, pp.423~431 (2015)
- Angiolillo DJ, "Bridging antiplatelet therapy with cangrelor in patients undergoing cardiac surgery : a randomized controlled trial", JAMA, 307, pp.265~274 (2012)
- Angiolillo DJ, "International expert consensus on switching platelet P2Y12 receptor-inhibiting therapies", Circulation, 136, pp.1955~1975 (2017)
- Banerjee S, "Use of antiplatelet therapy", DAPT for post-PCI patients undergoing noncardiac surgery, 2017, pp.69, 1861~1870
- Hong SJ, "Effect of perioperative antiplatelet therapy on outcomes in patients with drug-eluting stents undergoing elective noncardiac surgery", Am J Cardiol, 123, pp.1414~1421 (2019)
- 김병극, "Prospective and Systematic Analysis of Unexpected Requests for Non-Cardiac Surgery or Other Invasive Procedures during the First Year after Drug-Eluting Stent Implantation", Yonsei Medical Journal, 55(2), pp.345~352 (2014), 연세대학교의과대학[DOI]
- Kim C, "Patterns of antiplatelet therapy during noncardiac surgery in patients with second-generation drug-eluting stents", J Am Heart Assoc, 9, pp.e016218~ (2020)
- Keeling D, "Peri-operative management of anticoagulation and antiplatelet therapy", Br J Haematol, 175, pp.602~613 (2016)
- Raval AN, "Management of patients on non-vitamin K antagonist oral anticoagulants in the acute care and periprocedural setting: a scientific statement from the American Heart Association", Circulation, 135, pp.e604~e633 (2017)
- Kristensen SD, "2014 ESC", ESA guidelines on non-cardiac surgery: cardiovascular assessment and management: the joint task force on non-cardiac surgery: cardiovascular assessment and management of the European Society of Cardiology (ESC) and the European Society of Anaesthesiology (ESA), 2014, pp.35, 2383~2431
- Pengo V, "Standardized low-molecular-weight heparin bridging regimen in outpatients on oral anticoagulants undergoing invasive procedure or surgery:an inception cohort management study", Circulation, 119, pp.2920~2927 (2009)
- Steffel J, "The 2018 European Heart Rhythm Association practical guide on the use of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation", Eur Heart J, 39, pp.1330~1393 (2018)
- Douketis JD, "Perioperative bridging anticoagulation in patients with atrial fibrillation", N Engl J Med, 373, pp.823~833 (2015)
- Pollack CV Jr, "Idarucizumab for dabigatran reversal-full cohort analysis", N Engl J Med, 377, pp.431~441 (2017)