In patients who have undergone percutaneous coronary intervention after a heart attack, opting for anticoagulant treatment would limit the risk of long-term complications.
- Patients who have had percutaneous coronary intervention after a heart attack should take anticoagulant therapy.
- This would limit the risk of long-term complications, in particular stent thrombosis.
- Anticoagulants help thin the blood.
Every year, 80,000 people have a myocardial infarction – also called heart attack – in France, according to health insurance. It is part, with unstable angina, of acute coronary syndromes which result from the sudden obstruction of a coronary artery, that of the heart. After a heart attack some patients experience a percutaneous coronary intervention (PCI) during which the surgeon places a stent to keep this artery open.
Reduce the risk of complications
Before such an operation, there is a risk assessment and, once this has been carried out, the patient receives appropriate treatment. A study, presented at the congress of the Society for Cardiovascular Angiography & Interventions (SCAI), examines the risk criteria adopted by the European Society of Cardiology (ESC) in order to define the patients for whom a treatment with anticoagulant after a PCI would be the best option.
People at high risk – i.e. with diabetes, chronic kidney disease, etc. – and having undergone PCI after a heart attack may have better results with anticoagulant therapy. These drugs that thin the blood could notably reduce the risk of stent thrombosis. This is a serious but fairly rare complication: the formation of one or more blood clots inside the artery with the stent.
To reach this result, the scientists studied the health data of 11,787 patients with acute coronary syndrome who underwent PCI between 2012 and 2019. These were classified according to their risk of thrombosis – low (2,641 ), medium (5.286) and high (3.860) – according to the criteria of the ESC.
Anticoagulant treatment for patients at risk
The primary risk endpoint was major adverse cardiovascular events, including death from any cause, myocardial infarction, stroke. Major bleeding was part of the secondary endpoints. Thus, the study confirmed that patients meeting the criteria for ESC were more likely to experience complications due to blood clotting in the coronary arteries and therefore could derive greater benefit from anticoagulant therapy. .
“It is important to offer individualized cardiology care (…) adapted to the patient’s risk factorssays George Dangas, professor of cardiology and vascular surgery at theIcahn School of Medicine at Mount Sinaibased in New York, and lead author of this study, in a communicated. In this study, we are working on how to find the best anticoagulant for each patient. Assessing these criteria is an important step towards creating a more personalized tool to identify high-risk patients for whom anticoagulation therapy would benefit in the long term.”
