Madeline K Mahowald, Luis Ortega-Paz, Claudio Laudani, Dominick J Angiolillo
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Antiplatelet therapy following conservatively managed spontaneous coronary artery dissection.
Spontaneous coronary artery dissection (SCAD) is a relatively uncommon but increasingly recognized etiology of acute coronary syndrome (ACS). Conservative management is generally recommended, but optimal medical therapy is unknown. The majority of patients are discharged on dual antiplatelet therapy consisting of aspirin and a P2Y12 inhibitor based on trials and guidelines developed for ACS caused by plaque rupture and subsequent platelet activation and aggregation. Observational trials have shown conflicting results on the effects of antiplatelet therapy on major adverse cardiac events after SCAD. This manuscript provides a review of the available data, including a meta- analysis, and offers recommendations for antiplatelet therapy after conservatively managed SCAD in clinical practice.
期刊介绍：
The Journal of Thrombosis and Thrombolysis is a long-awaited resource for contemporary cardiologists, hematologists, vascular medicine specialists and clinician-scientists actively involved in treatment decisions and clinical investigation of thrombotic disorders involving the cardiovascular and cerebrovascular systems. The principal focus of the Journal centers on the pathobiology of thrombosis and vascular disorders and the use of anticoagulants, platelet antagonists, cell-based therapies and interventions in scientific investigation, clinical-translational research and patient care.
The Journal will publish original work which emphasizes the interface between fundamental scientific principles and clinical investigation, stimulating an interdisciplinary and scholarly dialogue in thrombosis and vascular science. Published works will also define platforms for translational research, drug development, clinical trials and patient-directed applications. The Journal of Thrombosis and Thrombolysis'' integrated format will expand the reader''s knowledge base and provide important insights for both the investigation and direct clinical application of the most rapidly growing fields in medicine-thrombosis and vascular science.
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