Management of antiplatelet therapy in patients undergoing elective invasive procedures. Proposals from the French Working Group on perioperative haemostasis (GIHP) and the French Study Group on thrombosis and haemostasis (GFHT). In collaboration with the French Society for Anaesthesia and Intensive Care Medicine (SFAR).

Published

Journal Article (Review)

The French Working Group on Perioperative Haemostasis (GIHP) and the French Study Group on Haemostasis and Thrombosis (GFHT) in collaboration with the French Society for Anaesthesia and Intensive Care Medicine (SFAR) drafted up-to-date proposals for the management of antiplatelet therapy in patients undergoing elective invasive procedures. The proposals were discussed and validated by a vote; all proposals but one could be assigned with a high strength. The management of antiplatelet therapy is based on their indication and the procedure. The risk of bleeding related to the procedure can be divided into high, moderate and low categories depending on the possibility of performing the procedure in patients receiving antiplatelet agents (none, monotherapy and dual antiplatelet therapy respectively). If discontinuation of antiplatelet therapy is indicated before the procedure, a last intake of aspirin, clopidogrel, ticagrelor and prasugrel 3, 5, 5 and 7 days before surgery respectively is proposed. The thrombotic risk associated with discontinuation should be assessed according to each specific indication of antiplatelet therapy and is higher for patients receiving dual therapy for coronary artery disease (with further refinements based on a few well-accepted items) than for those receiving monotherapy for cardiovascular prevention, for secondary stroke prevention or for lower extremity arterial disease. These proposals also address the issue of the potential role of platelet functional tests and consider management of antiplatelet therapy for regional anaesthesia, including central neuraxial anaesthesia and peripheral nerve blocks, and for coronary artery surgery.

Full Text

Duke Authors

Cited Authors

  • Godier, A; Fontana, P; Motte, S; Steib, A; Bonhomme, F; Schlumberger, S; Lecompte, T; Rosencher, N; Susen, S; Vincentelli, A; Gruel, Y; Albaladejo, P; Collet, J-P; members of the French Working Group on perioperative haemostasis (GIHP),

Published Date

  • August 2018

Published In

Volume / Issue

  • 37 / 4

Start / End Page

  • 379 - 389

PubMed ID

  • 29309950

Pubmed Central ID

  • 29309950

Electronic International Standard Serial Number (EISSN)

  • 2352-5568

Digital Object Identifier (DOI)

  • 10.1016/j.accpm.2017.12.012

Language

  • eng

Conference Location

  • France