Major bleeding: management and risk reduction in acute coronary syndromes.

Journal Article (Journal Article;Review)

BACKGROUND: Guidelines for the management of high-risk non ST-segment elevation acute coronary syndrome (NSTE ACS) recommend antithrombotic and antiplatelet therapy combined with an early invasive strategy. While this strategy reduces ischemic complications, it places patients at risk for bleeding complications. OBJECTIVE: We sought to provide a narrative review of the risk factors for bleeding, risks associated with bleeding and strategies to prevent bleeding complications. METHODS: A comprehensive literature review was performed to identify relevant evidence. RESULTS/CONCLUSIONS: Bleeding complications in NSTE ACS are associated with adverse events and higher mortality. Prevention of bleeding complications can be achieved through judicious dosing of medications, the use of antithrombotic agents associated with a lower bleeding risk and use of the radial artery approach in patients requiring coronary intervention. Future work should focus on delineating the mechanisms underlying the bleeding-mortality relationship and developing a better understanding of the tradeoff between efficacy and safety.

Full Text

Duke Authors

Cited Authors

  • Cavender, MA; Rao, SV; Ohman, EM

Published Date

  • August 2008

Published In

Volume / Issue

  • 9 / 11

Start / End Page

  • 1869 - 1883

PubMed ID

  • 18627326

Electronic International Standard Serial Number (EISSN)

  • 1744-7666

Digital Object Identifier (DOI)

  • 10.1517/14656566.9.11.1869


  • eng

Conference Location

  • England