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Thrombotic and bleeding risks: how best to balance in real world

Syed Raza

Antithrombotic treatment has revolutionized the medical management of cardiac patients. Over the past 20 years, the improvement of recent anti-thrombotic medications and schemes has decreased ischemic events very significantly. With every approach to decrease thrombosis, however, there is an accompanying risk of improving bleeding complications. Conversely, decreasing bleeding complications may increase thrombotic (ischemic) events. Due to increasing number of elderly populations, prevalence of thrombosis related complications and bleeding combined with anti-thrombotic therapy is constantly increasing. There are various tools to evaluate thrombotic risk but evaluation of bleeding risk is often neglected. Thrombosis and bleeding both increase impairment and death or mortality. Balancing both ends of the spectrum is important and a single approach to therapy is advocated. The author will show various strategies to stable the thrombotic and bleeding risk assessment. This demonstration will be of interest to physicians, cardiologists, haematologists, surgeons, anaesthetists and nurses.