(1)Management of Antiplatelet Drugs Around Minor Procedures (Dental, Dermatologic, Ophthalmologic),we suggest continuing the antiplateletdrug (ASA or P2Y12 inhibitor) over stopping the antiplatelet agent before the procedure. Patients who are receiving dual antiplatelet therapy with ASA and a P2Y12 inhibitor can continue ASA and interrupt the P2Y12 inhibitor.
(2)In patients receiving ASA who are undergoing elective non-cardiac surgery,we suggest ASA continuation over ASA interruption. In patients receiving ASA therapy whoare undergoing elective surgery and require ASA interruption, we suggeststopping ASA <7 days instead of 7 to 10 days before the surgery. Inpatients receiving clopidogrel who are undergoing an elective non-cardiacsurgery, we suggest stopping clopidogrel 5 days instead of 7 to 10 days beforethe surgery, stopping ticagrelor 3 to 5 daysinstead of 7 to 10 days before the surgery, stopping prasugrel 7 days instead of 7to 10 days before the surgery.In patients who require antiplatelet drug interruption we suggest to resume antiplatelet drugs <24 hours instead of > 24 hours after the surgery/procedure.
(3)In patients receiving antiplatelet drug therapy who areundergoing an elective surgery/procedure, we suggest against the routine use ofplatelet function testing prior to the surgery/procedure to guide perioperativeantiplatelet management
(围手术期没必要监测血小板功能)
(4)In patients receiving ASA and a P2Y12 inhibitor withcoronary stents placed within the last 6 to 12 weeks who are undergoing anelective surgery, we suggest either continuation of both antiplateletagents or stopping one antiplatelet agent within 7 to 10 days of surgery. within the last 3 to 12 months and are undergoing anelective surgery, we suggest stopping the P2Y12 inhibitor prior tosurgery over continuation of the P2Y12 inhibitor
(5)In patients with coronary stents who require continueddual antiplatelet therapy, we suggest delaying an elective surgery/procedureover not delaying the surgery/procedure. In patients with coronary stents who require interruption of antiplatelet drugs for an elective surgery, we suggest against routine bridging therapy with a glycoprotein IIb/IIIa inhibitor, cangrelor, or LMWH over routine use of bridging therapy