Clinical Physiology of Circulation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Antiplatelet therapy in patients with coronary artery disease undergoing elective coronary artery bypass grafting: real clinical practice against standards

Authors: Gvalia S.L., Buziashvili Yu.I., Grishenok A.V.

Company:
Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation

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DOI: https://doi.org/10.24022/1814-6910-2022-19-4-291-301

UDC: 615.273.55+616.12-005.4-089.843

Link: Clinical Physiology of Blood Circulaiton. 2022; 4 (19): 291-301

Quote as: Gvalia S.L., Buziashvili Yu.I., Grishenok A.V. Antiplatelet therapy in patients with coronary artery disease undergoing elective coronary artery bypass grafting: real clinical practice against standards. Clinical Physiology of Circulation. 2022; 19 (4): 291–301 (in Russ.). DOI: 10.24022/1814-6910-2022-19-4-291-301

Received / Accepted:  08.11.2022 / 21.12.2022

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Abstract

This review of the literature highlights the fundamental problems of the immediate and long-term postoperative period of coronary artery bypass grafting (CABG) and outlines considerations for new ways to optimize secondary prevention and prognosis. As is known, the most common major negative outcomes of CABG include, on the one hand, thrombotic complications underlying the bypass dysfunction, and, on the other hand, hemorrhagic complications. They are mainly associated with deviations of the hemorheological properties of the blood, and platelets play a key role in this. Accordingly, the main focus of discussions is on the perioperative use of antiplatelet agents. If for patients in acute pathology there is a wellestablished consensus recommendation for the mandatory appointment of DAPT at the earliest stages of CABG, then for patients with stable forms of coronary artery disease, due to the limited clinical data, things are different. Today it is impossible not to notice a number of problems associated with the triviality of the therapeutic approach to these patients. The current situation forces us to recognize the prospects of developing new approaches to making a clinical decision regarding antiplatelet therapy (APT). In particular, a personalized approach based on monitoring the effectiveness and safety of APT seems to be a very reasonable concept. In particular, a personalized approach based on monitoring the effectiveness and safety of APT seems to be a very reasonable concept.

About Authors

  • Sofia L. Gvalia, Postgraduate; ORCID
  • Yuriy I. Buziashvili, Dr. Med. Sci., Professor, Academician of the Russian Academy of Sciences, Head of the Clinical-Diagnostic Department; ORCID
  • Alena V. Grishenok, Postgraduate; ORCID

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