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BÀI TỔNG QUAN. Issue: Số 117

Recent Advances in Guideline Recommendations on Anticoagulant Therapy for Percutaneous Coronary Intervention

Trương Quang Bình: BV ĐH Y Dược TP. Hồ Chí Minh;
Published: September 30, 2025
Views: 42
DOI 10.58354/jvc.117.2025.956

Abstract

Background: Intravenous anticoagulants are the cornerstone of percutaneous coronary intervention (PCI), reducing thrombotic complications during and after the procedure. However, their use requires a careful balance between antithrombotic efficacy and bleeding risk.

Methods: This review summarizes and analyzes recent evidence and compares recommendations from international guidelines (ACC/AHA 2025, ESC 2023), focusing on the selection, dosing, and indications of anticoagulants used in PCI, including UFH, low-molecular-weight heparins, bivalirudin, fondaparinux, and enoxaparin.

Results: Anticoagulation is recommended for all patients with acute coronary syndromes, with UFH or bivalirudin as preferred options in both STEMI and NSTE-ACS. In patients with atrial fibrillation or on chronic anticoagulation therapy, drug selection and timing of discontinuation/reinitiation are critical to minimize both bleeding and thrombotic risks. New-onset atrial fibrillation after PCI increases the risk of mortality and stroke, requiring appropriate anticoagulation strategies.

Conclusions: No single anticoagulant is optimal for all PCI patients. Selection should be individualized based on clinical context, bleeding and thrombotic risks, and renal function.

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Section BÀI TỔNG QUAN.
Issue Số 117
Pages 29-42