Cardiovascular risk associated with interruption of antiplatelet and oral anticoagulation therapy.

A number of clinical situations are associated with increased risk for atherothrombosis (for example coronary stents) or thromboembolism (such as mechanical heart valves). Large numbers of patients are under regular medication with antiplatelet agents or anticoagulants, which carries an increased hemorrhagic risk in the setting of a surgical procedure. On the other hand, the interruption of antithrombotic drugs restores the risk of the baseline condition and puts the patient in a vulnerable situation. The authors review the recent literature on this topic and propose practical algorithms to help clinical decisions.