Antithrombotics: indications and management

Scottish Intercollegiate Guidelines Network

Although antithrombotics show proven benefit in a range of indications, these drugs are associated with adverse effects, principally abnormal bleeding. In many cases, patients who may gain most from antithrombotic treatment are also those at high risk of bleeding, such as the elderly with comorbidities. The use of combinations of antithrombotics, with inevitable additional bleeding risk, is expanding, for example after percutaneous coronary artery interventions. To maximise benefit over risks, the selection of patients for treatment with antithrombotics and their management should be evidence based.

This Guidelines summary covers antiplatelet therapy, parenteral and oral anticoagulant therapy, and thrombolytic therapy for prophylaxis and treatment in a range of clinical conditions such as atrial fibrillation, peripheral arterial disease, and cerebrovascular disease.

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