Management of Acute Coronary Syndrome in Patients With Liver Cirrhosis

Taha Ahmed; Alla Y. Grigorian; Adrian W. Messerli


Am J Cardiovasc Drugs. 2022;22(1):55-67. 

In This Article

Conclusions and Future Directions

With the scarcity of available literature on management of ACS in LC patients, it still remains a daunting clinical scenario for physicians, leading to adaptation of risk-averse behaviors and poor outcomes. With the increasing prevalence of chronic alcoholism, diabetes mellitus, obesity, and NAFLD, the prevalence of LC patients having ACS is on the rise. Therefore, an optimal strategy in LC patients with ACS needs to be better delineated. Data on the safety and efficacy of antithrombotic and anticoagulant therapies in LC patients are largely derived from observational studies in patients with mild to moderate (Child–Pugh class A and B) LC. Optimal duration of DAPT in LC patients still remains to be defined by randomized controlled trials.

An expert consensus cross-specialty panel should be established to guide clinicians in the optimal management of ACS in LC patients. We encourage trialists and trial sponsors to consider including LC patients to allow comprehensive and consistent assessment of ACS outcomes in this patient cohort.