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Bleeding and haemostasis disorders 

Bleeding and haemostasis disorders
Bleeding and haemostasis disorders

Pier Mannuccio Mannucci

and Maddalena Lettino



7 new references; 3 new further readings

Added the precise DAPT score and the ESC DAPT recommendations

Updated 1 Table (including cangrelor)

Updated on 22 February 2018. The previous version of this content can be found here.
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date: 09 July 2020

The main cause of haemostasis defects and related bleeding complications in patients with acute coronary syndromes admitted to the intensive cardiac care unit is the use of multiple antithrombotic drugs, alone or concomitantly with invasive procedures such as percutaneous coronary intervention with stent deployment and coronary artery bypass surgery. These drugs, that act upon several components of haemostasis (platelet function, coagulation, fibrinolysis), are associated with bleeding complications, particularly in elderly patients (more so in women than in men), those who are underweight, and those with comorbid conditions such as renal and liver insufficiency and diabetes. The identification of patients at higher risk of bleeding is the most important preventive strategy. Red cell and platelet transfusions, which may become necessary in patients with severe bleeding, should be used with caution, because transfused patients with acute coronary syndrome have a high rate of adverse outcomes (death, myocardial infarction, and stroke).

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