Individual Ischemia and Hemorrhagic Risk Assessment and Prediction of Antithrombotic Therapy

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About this Research Topic

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Background

Antithrombotic therapy plays an essential role in patients with established coronary artery disease, especially those after percutaneous coronary intervention. With the advancement of antithrombotic medications, multiple therapeutic options are now available for routine clinical use, including dual antiplatelet therapy (DAPT), dual pathway inhibition (DPI), etc. The effectiveness and safety of these antithrombotic therapies, however, remains under heated debate.

Faced with the trade-off between ischemic and hemorrhagic risks, selecting the optimal antithrombotic regimen and duration depends on the precise evaluation of risk profiles for each individual. A variety of contributing factors, including clinical presentation, baseline characteristics, past history, race/ethnicity and procedural intervention, determines individual risk profiles. Despite concerted efforts to develop risk predicting models, ischemic or hemorrhagic adverse event still occurs. Furthermore, novel antithrombotic agents and interventional techniques might require less antithrombotic intensity, reducing the probability of potential side effects. All these factors are calling for robust research studies on individual risk assessment, which ultimately helps to tailor antithrombotic therapies to the need of each individual patient.

In this Research Topic, we would like to create a forum for current advances on antithrombotic therapy in patients with coronary artery disease (particularly those undergoing percutaneous coronary intervention), including but not limited to: late-breaking clinical trials or observational studies on safety and effectiveness of various anticoagulant and antiplatelet regimens (dual antiplatelet therapy (DAPT), dual pathway inhibition (DPI), etc.), pharmacodynamic (PD) and pharmacokinetic (PK) studies on novel antithrombotic agents, derivation and validation of novel scoring tools to assess individual ischemia/bleeding risks and long-term prognostication associated with tool-guided antithrombotic strategies.

We welcome Original Article, Clinical Trial, Review and Mini Review in the subtopics of interest, which include, but are not limited to:
• Derivation of novel ischemic/hemorrhagic risk scores in patients with CAD
• External validation studies on established ischemic/hemorrhagic risk assessment tools
• Pharmacodynamic (PD) / Pharmacokinetic (PK) studies on novel antithrombotic agents approved for clinical use on patients with CAD (with or without PCI)
• Outcomes/prognosis in patients treated with risk score-guided antithrombotic strategy
• Testing novel interventional techniques/equipments (Biodegradable-Polymer Drug Eluting Stents, Bioresorbable Scaffolds, Drug-Coated Balloons, etc.) that might require less intensive antithrombotic therapy for CAD patients undergoing PCI
• Artificial intelligence (e.g. machine learning) in developing models evaluating ischemic/hemorrhagic risk profiles

Keywords: Ischemia, hemorrhage, risk assessment, antithrombotic therapy, prognosis

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