PERIOPERATIVE MANAGEMENT OF INDIVIDUALS WITH ANTICOAGULANT AND ANTIPLATELET THERAPY

Introduction: The increased use of anticoagulant therapy and antiplatelet therapy requires careful management, especially in patients requiring surgery. These treatments include oral and parenteral options which must be balanced with the risk of bleeding and thrombosis. They are fundamental in both prevention and treatment of thromboembolic events. Objective: to present clear and precise recommendations for the perioperative management of TAC and antiplatelet agents. Methodology: a total of 30 articles were analyzed in this review, including review and original articles, as well as clinical cases, of which 17 bibliographies were used because the other articles were not relevant for this study. The sources of information were PubMed, Google Scholar and Cochrane; the terms used to search for information in Spanish, Portuguese and English were: oral anticoagulants, antiplatelet agents, TACO, antithrombolytic therapy, new oral anticoagulants. Results: the study showed that restarting low molecular weight heparins in therapeutic doses before 24 hours post-surgery increases the risk of bleeding, so it is recommended to use prophylactic doses. Furthermore, it emphasizes the importance of adjusting anticoagulant therapy according to the thromboembolic and hemorrhagic risk of each patient. Conclusions: anticoagulant and antiplatelet drugs are essential to prevent thromboembolic events in pathologies such as acute coronary syndrome and cerebrovascular diseases. Their perioperative management should consider the thrombotic and hemorrhagic risk, as well as the type of surgery and drug. Heparins, vitamin K antagonists and new oral anticoagulants require adjustments in doses and withdrawal times to prevent complications. In addition, reversal of their anticoagulant effect in emergencies is key, with advances in agents such as idarucizumab and andexanet alfa for greater effectiveness in critical situations. KEY WORDS: TACO, anticoagulants, antiplatelet agents.