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July 18, 2026Current Cardiology Reports

BioRender licensing document confirms publication rights and contains no clinical trial data.

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Population

High-risk and underrepresented populations undergoing percutaneous coronary intervention, including patients…

Design

Review

Key result

This document is a confirmation of publication and licensing rights from BioRender and does not contain clinical trial data.

Authors

TATanawat AttachaipanichTATania AhujaSSSamin K Sharma

Discussion

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Overview

Evidence remains limited for intraprocedural anticoagulation in PCI with advanced CKD or cirrhosis; leaves open optimal strategies pending dedicated trials.

Key Points

  • This review aims to summarize current knowledge on anticoagulation in high-risk populations during PCI and identify gaps in evidence.
  • Reviewed current literature on anticoagulation strategies in patients with advanced CKD, cirrhosis, and those undergoing PCI.
  • Discussed the impact of mechanical circulatory support, pharmacogenomics, and machine learning in anticoagulation.
  • Identified limitations in predictive tools and the need for prospective studies.
  • Anticoagulation strategies for STEMI post-fibrinolytic therapy remain uncertain, with potential benefits from continuity of anticoagulation.
  • High-risk populations demonstrate reduced predictive performance from conventional bleeding risk scores.
  • Emerging evidence supports precision-guided anticoagulation, accounting for patient-specific factors and integrating machine learning.

Structured PICO

P
Population
High-risk and underrepresented populations undergoing percutaneous coronary intervention (PCI), including patients with advanced chronic kidney disease (CKD) or end-stage renal disease, cirrhosis, nonagenarians, thrombocytopenia, chronic oral anticoagulation, mechanical circulatory support, and STEMI following fibrinolytic therapy
I
Intervention
Precision-guided intraprocedural anticoagulation strategies (individualized selection, dosing, and monitoring)

Precision-guided anticoagulation strategies are necessary for high-risk populations undergoing PCI, as conventional risk scores and standard approaches are often insufficient.

Limitations

  • Most available evidence remains extrapolated from broader populations
  • Conventional bleeding risk scores demonstrate reduced predictive performance in these populations

Cite This Study

Attachaipanich et al. (2026) studied this question. This document is a confirmation of publication and licensing rights from BioRender and does not contain clinical trial data.

synapsesocial.com/papers/6a5b3a698167787360d24f9ahttps://doi.org/10.1007/s11886-026-02391-3
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