Title:Antiplatelet for Coronary Artery Disease in Specific Condition “No Size Fits All”
Volume: 24
Issue: 4
Author(s): Benny M. Setiadi, Beny Hartono, Adhitia B. Prakoso, Anggia C. Lubis, Reza M. Munandar and Muhammad Munawar*
Affiliation:
- Binawaluya Cardiac Center, Jakarta,Indonesia
Keywords:
Antiplatelet, coronary artery disease, diabetes mellitus, elderly, renal dysfunction, atrial fibrillation.
Abstract: Antiplatelet is the cornerstone therapy for patient with coronary artery disease. Several comorbidities
can influence the efficacy and safety of antiplatelet agent. Diabetes mellitus is characterized by increased platelet
reactivity and reduced response to antiplatelet. Elderly patients have both reduced response to antiplatelet and
increased risk of bleeding. Patients with renal dysfunction also had decreased efficacy of antiplatelet
accompanied with increased risk of bleeding. In patients with atrial fibrillation, the concomitant use of
anticoagulant with antiplatelet poses an increased risk of bleeding. In patients with these comorbidities, caution
should be stressed in selecting the best regimen of antiplatelet which translates the most optimal efficacy while
minimizing the risk of adverse events. In this review, we will discuss the platelet changes in these comorbidities,
current evidence of antiplatelet usage in these group of patients and current recommendation.
