For patients receiving DAPT scheduled to undergo a procedure associated with high bleeding risk, the patient’s thrombotic risk, which is related to the duration of DAPT and to the original indication (eg, cardiac vs peripheral stent), must be taken into consideration. For patients receiving DAPT scheduled to undergo a procedure associated with low bleeding risk, most antiplatelet agents can be continued. The management of antiplatelet agents before a procedure is dependent on the assessment of the patient’s overall clinical status, thrombotic and bleeding risks, and the procedure-associated bleeding risk. It should be noted that this figure is reflective of recommendations for patients receiving anticoagulation medication with the assumptions that no other coagulation defect is present and that no other drug that may affect coagulation status has been administered.įigure 2 Management of dual antiplatelet therapy (DAPT) before a procedure (see Table 6 for specific recommendations). For a patient who plans to undergo a procedure associated with a high bleeding risk or a patient who has a high risk of bleeding, regardless of procedural risk, additional factors need to be considered. In this case, the patient’s thromboembolic risk, whether high or low, does not influence the clinical decision. For a patient who plans to undergo a procedure associated with a low bleeding risk with no or minimal bleeding risk factors, most anticoagulant agents can be continued. The management of anticoagulation agents before a procedure depends on the patient’s overall clinical status, thromboembolic and bleeding risks, and the procedure-associated bleeding risk. Figure 1 Management of anticoagulation agents before a procedure (see Table 6 for agent-specific recommendations).
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