CASEBOOK CHALLENGES: INDIVIDUALIZING ANTIPLATELET THERAPY IN THE EMERGENCY DEPARTMENT - DIALOGUE WITH THE EXPERTS.

摘要

For the emergency department (ED) clinician, the choice of initial antiplatelet and other antithrombotic therapies for the patient presenting with high-risk acute coronary syndrome (ACS) can represent a challenge. Fundamental issues remain assessing patients' risk for ischemic events and balancing it with the inherent risk of bleeding, understanding the efficacy and safety of available therapies for thrombosis prevention in the context of individual patient factors, and understanding how the management strategy moving forward (eg, conservative vs invasive) affects initial antithrombotic therapy decisions. Beyond determining if a patient's symptoms are due to ACS, early risk stratification in the ED involves using validated tests and tools (eg, cardiac marker testing, risk scoring instruments) to determine a patient's likelihood of an adverse cardiac outcome.