Antithrombotic therapies in aortic and peripheral arterial diseases in 2021: a consensus document from the ESC working group on aorta and peripheral vascular diseases, the ESC working group on thrombosis, and the ESC working group on cardiovascular pharmacotherapy

Victor Aboyans, Rupert Bauersachs, Lucia Mazzolai, Marianne Brodmann, José F Rodriguez Palomares, Sebastian Debus, Jean-Philippe Collet, Heinz Drexel, Christine Espinola-Klein, Basil S Lewis, Marco Roffi, Dirk Sibbing, Henrik Sillesen, Eugenio Stabile, Oliver Schlager, Marco De Carlo

Abstract

The aim of this collaborative document is to provide an update for clinicians on best antithrombotic strategies in patients with aortic and/or peripheral arterial diseases. Antithrombotic therapy is a pillar of optimal medical treatment for these patients at very high cardiovascular risk. While the number of trials on antithrombotic therapies in patients with aortic or peripheral arterial diseases is substantially smaller than for those with coronary artery disease, recent evidence deserves to be incorporated into clinical practice. In the absence of specific indications for chronic oral anticoagulation due to concomitant cardiovascular disease, a single antiplatelet agent is the basis for long-term antithrombotic treatment in patients with aortic or peripheral arterial diseases. Its association with another antiplatelet agent or low-dose anticoagulants will be discussed, based on patient's ischaemic and bleeding risk as well therapeutic paths (e.g. endovascular therapy). This consensus document aims to provide a guidance for antithrombotic therapy according to arterial disease localizations and clinical presentation. However, it cannot substitute multidisciplinary team discussions, which are particularly important in patients with uncertain ischaemic/bleeding balance. Importantly, since this balance evolves over time in an individual patient, a regular reassessment of the antithrombotic therapy is of paramount importance.

OriginalsprogEngelsk
TidsskriftEuropean Heart Journal
Vol/bind42
Udgave nummer39
Sider (fra-til)4013-4024
Antal sider12
ISSN0195-668X
DOI
StatusUdgivet - 14 okt. 2021

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