Bleeding in acute coronary syndrome: from definitions, incidence, and prognosis to prevention and management

Expert Opin Drug Saf. 2023 Dec 4. doi: 10.1080/14740338.2023.2291865. Online ahead of print.ABSTRACTINTRODUCTION: In patients with an acute coronary syndrome (ACS), the ischemic benefit of antithrombotic treatment is counterbalanced by the risk of bleeding. The recognition that a bleeding event has prognostic implications (i.e. mortality) similar to a recurrent ischemic event led to the development of treatment regimens aimed at balancing both ischemic and bleeding risks.AREAS COVERED: This review aims at describing definitions, incidence and prognosis related to bleeding events in ACS patients as well as bleeding-avoidance strategies for their prevention and management of bleeding complications.EXPERT OPINION: Management of ACS patients has witnessed remarkable progress after the shift in focusing on the trade-off between ischemia and bleeding. Efforts in standardizing bleeding definitions will allow for better defining the prognostic impact of different types of bleeding events and enable to identify the high-bleeding risk patient. Such efforts will allow to balance the trade-off between the thrombotic and bleeding risk of the individual patient translating into better downward diagnostic and therapeutic decision making. Novel strategies aiming at maximizing the safety and efficacy of antithrombotic regimens as well as the development of novel antithrombotic drugs and reversal agents and technological advances will allow for optimization of bleeding-avoidance strategies and...
Source: Expert Opinion on Drug Safety - Category: Drugs & Pharmacology Authors: Source Type: research