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Avec l’avènement des nouveaux anticoagulants oraux dans la prise en charge de la fibrillation auriculaire et l’augmentation des comorbidités de ce genre de maladies, leur utilisation concomitante avec les antiagrégants plaquettaires pose de plus en plus question. En effet, les risques de saignement d’une triple thérapie, prise en charge classique d’un syndrome coronarien aigu et/ou d’une intervention coronarienne percutanée, ne sont plus à démontrer et viennent à balancer l’efficacité d’une telle thérapie. Il devient alors impératif de définir quel traitement serait le plus judicieux dans une telle situation, question à laquelle ce mémoire a tenté de répondre en réalisant une revue systématique de la littérature à ce sujet et en proposant des pistes de traitements alternatifs moins dangereux. Ce mémoire conclut alors que le rivaroxaban en bithérapie avec le clopidogrel semble être l’alternative la plus sûre. Cependant, le manque d’étude sur le sujet renforce l’idée qu’il est plus que nécessaire d’investiguer davantage les différentes possibilités qui existent pour la prise en charge de patients souffrant à la fois de FA et d’un SCA. With the advent of new oral anticoagulants in the management of atrial fibrillation and the increase of comorbidities from this kind of diseases, their concomitant use with platelet aggregation inhibitors raise more and more the question. Indeed, the risks of bleeding from a triple therapy, conventional management of acute coronary syndrome and / or percutaneous coronary intervention, are well established and come to balance the effectiveness of such therapy. It then becomes imperative to define which treatment would be the most judicious in such situation, a question to which this essay has tried to answer by carrying out a systematic review of the literature on this subject and proposing less dangerous alternative treatment. This essay leads to the conclusion that rivaroxaban in dual therapy with clopidogrel seems to be safest alternative. However, the lack of study on the subject reinforces the idea that is more than necessary to fully investigate the different possibilities that exist for the management of patients suffering from both FA and SCA.

Platelet Aggregation Inhibitors --- Anticoagulants

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Platelet Transfusion --- Blood Transfusion

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Platelets, Fourth Edition, integrates the entire field of platelet biology, pathophysiology, and clinical medicine with contributions from 142 world experts from 18 countries. This award-winning reference provides clear presentations by basic scientists on the cellular, molecular, and genetic mechanisms of platelets and the role of platelets in thrombosis, hemorrhage, inflammation, antimicrobial host defense, wound healing, angiogenesis and cancer. It also provides start-of-the-art presentations by hematologists, cardiologists, stroke physicians, blood bankers, pathologists and other clinicians on platelet function testing, disorders of platelet numbers and function, antiplatelet therapy and therapy to increase platelet numbers and/or function. Since the publication of the Third Edition of Platelets, there has been a rapid expansion of knowledge in both basic biology of platelets and the clinical approach to platelet-related diseases. This Fourth Edition of Platelets draws all this information into a single, comprehensive and authoritative resource.

Blood platelets. --- Blood Platelets. --- Blood Platelet Disorders. --- Thrombocytopathy --- Blood Platelet Disorder --- Disorder, Blood Platelet --- Disorders, Blood Platelet --- Platelet Disorder, Blood --- Platelet Disorders, Blood --- Thrombocytopathies --- Platelets --- Thrombocytes --- Blood Platelet --- Platelet --- Platelet, Blood --- Platelets, Blood --- Thrombocyte --- Blood cells --- Megakaryocytes

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Blood platelet disorders --- Blood Platelet Disorders --- Blood Platelets --- physiology

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Platelets have become an important research target for clinicians and basic scientists in a range of medical disciplines. This book reviews current science and applications in fields including thrombosis and hemostasis, signal transduction, and non-thrombotic conditions such as inflammation, allergy and tumor metastasis. It is a detailed, up-to-date, highly referenced text for clinical scientists and physicians, including recent developments in this rapidly expanding field. More than a scientific resource, this is also an authoritative reference and guide to the diagnosis and therapeutics of diseases involving platelets. Chapters are devised to provide a critical review of the most clinically relevant aspects of the subject. It will be an essential reference for biomedical scientists and clinicians in hematology, vascular medicine, cardiology, thrombosis and related disciplines.

Blood platelet disorders. --- Blood platelets --- Blood platelet receptors --- Platelet membrane receptors --- Platelet receptors --- Cell receptors --- Thrombocytopathy --- Blood --- Adhesiveness, Blood platelet --- Aggregation, Blood platelet --- Blood platelet aggregation --- Platelet adhesiveness --- Platelet aggregation --- Cell aggregation --- Receptors. --- Aggregation. --- Diseases --- Blood platelet disorders --- Blood Platelet Disorders --- Blood Platelets --- Platelet Aggregation Inhibitors --- Aggregation --- Receptors --- physiopathology --- drug effects --- pathology --- physiology --- therapeutic use