RESUMO
During the last few years, the number of patients receiving anticoagulant and antiplatelet therapy has increased worldwide. Since this is a chronic treatment, patients receiving it can be expected to need some kind of surgery or intervention during their lifetime that may require treatment discontinuation. The decision to withdraw antithrombotic therapy depends on the patient's thrombotic risk versus hemorrhagic risk. Assessment of both factors will show the precise management of anticoagulant and antiplatelet therapy in these scenarios. The aim of this consensus document, coordinated by the Cardiovascular Thrombosis Working Group of the Spanish Society of Cardiology, and endorsed by most of the Spanish scientific societies of clinical specialities that may play a role in the patient-health care process during the perioperative or periprocedural period, is to recommend some simple and practical guidelines with a view to homogenizing daily clinical practice.
Assuntos
Anticoagulantes/uso terapêutico , Fibrinolíticos/uso terapêutico , Hemorragia/etiologia , Inibidores da Agregação Plaquetária/uso terapêutico , Tromboembolia/etiologia , Idoso , Idoso de 80 Anos ou mais , Substituição de Medicamentos , Feminino , Hemorragia/prevenção & controle , Humanos , Cuidados Intraoperatórios/métodos , Masculino , Cuidados Pré-Operatórios/métodos , Medição de Risco , Fatores de Risco , Tromboembolia/prevenção & controleAssuntos
Neoplasias/complicações , Embolia Pulmonar/terapia , Tromboembolia Venosa/terapia , Trombose Venosa/terapia , Anticoagulantes/uso terapêutico , Terapia Combinada , Fibrinolíticos/uso terapêutico , Humanos , Neoplasias/diagnóstico , Prevenção Primária/métodos , Prognóstico , Embolia Pulmonar/diagnóstico , Embolia Pulmonar/etiologia , Fatores de Risco , Filtros de Veia Cava , Tromboembolia Venosa/diagnóstico , Tromboembolia Venosa/etiologia , Trombose Venosa/diagnóstico , Trombose Venosa/etiologiaAssuntos
Aneurisma/complicações , Aneurisma/cirurgia , Anormalidades Cardiovasculares/complicações , Anormalidades Cardiovasculares/cirurgia , Transtornos de Deglutição/etiologia , Procedimentos Endovasculares , Transtornos de Deglutição/complicações , Transtornos de Deglutição/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Artéria Subclávia/anormalidades , Artéria Subclávia/cirurgia , Procedimentos Cirúrgicos Vasculares/métodosAssuntos
Histiocitoma Fibroso Maligno/patologia , Neoplasias de Tecidos Moles/patologia , Úlcera Varicosa/patologia , Idoso , Progressão da Doença , Histiocitoma Fibroso Maligno/cirurgia , Humanos , Imageamento por Ressonância Magnética , Masculino , Prognóstico , Neoplasias de Tecidos Moles/cirurgia , Úlcera Varicosa/cirurgiaRESUMO
Because of the increase in life expectancy, peripheral artery disease (PAD) has become a major health problem. A study performed in Spain in persons aged more than 65 years old found an overall prevalence of PAD of 9.9%. The most important risk factors for PAD were smoking, diabetes mellitus, advanced age, hyperlipidemia and hypertension. Treatment includes smoking cessation, exercise, statins, platelet antiaggregants, cilostazol or hemorheologic agents, and revascularization techniques. Data from the Spanish arm of REACH indicate that the PAD subgroup shows the poorest control of blood pressure and cholesterol and that use of platelet antiaggregants and statins is lowest in these patients, indicating that therapeutic and preventive strategies are not being correctly applied.