Balance of ischemia and bleeding in selecting an antithrombotic regimen

Complications after percutaneous coronary intervention (PCI) are of 2 types: ischemic and bleeding. This article provides strategies to individualize pharmacologic regimens after PCI based on periprocedural risk assessment. A practical method to assess whether a patient is at risk for ischemic or bleeding complications is the use of risk scores. Patients at a low risk of bleeding benefit from aggressive antithrombotic therapy. Patients at a high risk of bleeding benefit from selective use of antithrombotic agents. As a large number of antithrombotic agents are currently available, individualization of the antithrombotic drug regimes should be considered in every patient.