J Transcat Intervent.2020;28:eA20190013.
High risk of bleeding in elderly patient with coronary artery disease
Carlos Vinicius Espírito Santo
, Yuri Galindo, Vitor Almeida, Adriano Martins Oliveira, Luiz Eduardo Ritt, Eduardo Darze
DOI: 10.31160/JOTCI202028A20190013
ABSTRACT
Individuals at high risk of bleeding comprise a significant portion of patients submitted to coronary angioplasty. The optimal duration of dual antiplatelet therapy for these patients remains uncertain, and the use of risk stratification scores for hemorrhagic and ischemic complications, such as PRECISE-DAPT and DAPT, help in the decision-making process. We report the case of an octogenarian patient with known high risk of bleeding (PRECISE-DAPT = 65; DAPT = 0) diagnosed with two chronic subdural hematomas, 4 weeks after angioplasty with placement of drug-eluting stent to treat coronary artery disease. Based on the latest evidence from the literature on the management of antiplatelet agents for this group of patients, the decision was for early discontinuation of clopidogrel on the 31st day after angioplasty. The clinical course was successful over 24-month follow-up.
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