Key result
Discontinuing antiplatelet therapy when starting therapeutic anticoagulation prevents increased bleeding risk, per guidelines.
Why the study?
Discontinuation of antiplatelet therapy upon initiation of therapeutic anticoagulation is recommended to reduce bleeding risk, but practical management guidance is needed.
Should antiplatelet therapy be discontinued when therapeutic anticoagulation is initiated for patients in secondary prevention of atherothrombotic cardiovascular events?
Should antiplatelet therapy be discontinued when therapeutic anticoagulation is initiated for patients in secondary prevention of atherothrombotic cardiovascular events?
This review emphasizes that to minimize bleeding risk, antiplatelet therapy should generally be discontinued when a patient requires therapeutic anticoagulation, aligning with current international guidelines.
May warrant antiplatelet discontinuation when anticoagulation is indicated; leaves open optimal strategies by patient and regimen.
The net clinical benefit of antiplatelet agents in the secondary prevention of atherothrombotic cardiovascular events has been widely demonstrated. This recognized efficacy explains the usual reluctance to consider discontinuation such treatment in clinical practice. Discontinuation of antiplatelet therapy should nevertheless be considered in a frequent situation, when an indication for therapeutic anticoagulation arises, as combining two antithrombotic agents significantly increases the risk of bleeding. Current international guidelines recommend discontinuing antiplatelet therapy whenever possible upon initiating therapeutic anticoagulation. Using a clinical case study, this article provides an up-to-date, practical overview of antiplatelet management when introducing therapeutic anticoagulation.
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Sills et al. (2026) conducted a review in Atherothrombotic cardiovascular disease requiring therapeutic anticoagulation. Discontinuation of antiplatelet therapy vs. Continuation of antiplatelet therapy was evaluated. Discontinuing antiplatelet therapy upon initiating therapeutic anticoagulation is recommended by current guidelines to avoid significantly increasing the risk of bleeding.
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