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Canadian Journal of Cardiology

The Evolution of Anticoagulation for Percutaneous Coronary Intervention:A 40-Year Journey

      STRUCTURED ABSTRACT

      The selection of antithrombotic strategies continue to be of utmost importance during percutaneous coronary intervention (PCI) and have evolved over the last 40 years. While the backbone of therapy during PCI continue to be a combination of oral anti-platelets and parenteral anticoagulants, a variety of different approaches have been tested over time. In particular, different choices of anticoagulation management have been tested in both the stable ischemic heart disease (SIHD) and acute coronary syndrome (ACS) setting. Evaluation of alternative regimens in the quest to balance ischemic and bleeding risk have undoubtedly improved upon patient care with PCI. The current review highlights the evolution of evidence-based therapeutic options over the past 40 years from the beginning of coronary angioplasty to contemporary PCI. We provide insight into future therapeutic options and provide a contemporary overview of anticoagulation choices for patients requiring PCI based on up-to-date evidence balancing ischemic and bleeding risk and according to clinical presentation.
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