Copyright
©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Nov 26, 2021; 13(11): 599-607
Published online Nov 26, 2021. doi: 10.4330/wjc.v13.i11.599
Published online Nov 26, 2021. doi: 10.4330/wjc.v13.i11.599
Safety and efficacy of dual antiplatelet therapy after percutaneous coronary interventions in patients with end-stage liver disease
Zvonimir Ostojic, Department of Cardiology, University Clinical Hospital Zagreb, Zagreb 10000, Croatia
Ana Ostojic, Anna Mrzljak, Department of Gastroenterology and Hepatology, University Hospital Center, Zagreb 10000, Croatia
Josko Bulum, Department of Cardiovascular Diseases, University Hospital Center Zagreb, University Clinical Hospital Zagreb, Zagreb 10000, Croatia
Josko Bulum, Anna Mrzljak, School of Medicine, University of Zagreb, Zagreb 10000, Croatia
Author contributions: Ostojic Z and Ostojic A made contributions to the conception and design of the study, collected the data and drafted the manuscript; Bulum J and Mrzljak A revised the manuscript critically; all authors read and approved the final manuscript.
Conflict-of-interest statement: The authors declare no conflict interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ana Ostojic, MD, PhD, Senior Postdoctoral Fellow, Department of Gastroenterology and Hepatology, University Hospital Center Zagreb, Kispaticeva 12, Zagreb 10000, Croatia. ostojicana.zg@gmail.com
Received: March 23, 2021
Peer-review started: March 23, 2021
First decision: July 30, 2021
Revised: August 6, 2021
Accepted: October 25, 2021
Article in press: October 25, 2021
Published online: November 26, 2021
Peer-review started: March 23, 2021
First decision: July 30, 2021
Revised: August 6, 2021
Accepted: October 25, 2021
Article in press: October 25, 2021
Published online: November 26, 2021
Core Tip
Core Tip: Dual antiplatelet therapy (DAPT) is necessary after a percutaneous coronary intervention (PCI). However, it could result in severe consequences in patients with liver cirrhosis. Based on novel findings, liver cirrhosis does not necessarily lead to a significant increase in bleeding complications. Patients with cirrhosis who have the highest bleeding risk are those with severe thrombocytopenia and elevated portal pressure. Despite the lack of solid evidence for DAPT in patients with cirrhosis, trials investigating one month of DAPT duration after PCI can be implemented in cirrhotic patients. Before PCI, functional assessment of coronary artery disease severity should be performed to avoid unnecessary interventions.