Editorials
16 April 2025
Vol. 4 No. 2 (2025)
https://doi.org/10.4081/btvb.2025.178

2024 EACTS guidelines on perioperative medication in adult cardiac surgery: embracing precision medicine driven by strong evidence-based methodology

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cardiac surgery, guidelines, antiplatelet therapy, anticoagulant therapy, surgery, evidence-based medicine, personalized medicine
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Authors

Bianca Rocca
rocca@lum.it
https://orcid.org/0000-0001-8304-6423
Department of Medicine and Surgery, LUM University, Casamassima, Bari, Italy.
Emma Hansson
Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Gothenburg; Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden.
Milan Milojevic
https://orcid.org/0000-0003-0984-9011
Departments of Cardiac Surgery and Cardiovascular Research, Dedinje Cardiovascular Institute, Belgrade, Serbia.
Anders Jeppsson
Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Gothenburg; Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden.

Guidelines are pivotal for optimal patient management and should be grounded by evidence-based medicine with accurate methodology.1 The European Association of Cardio-Thoracic Surgery has recently released the “2024 EACTS Guidelines on Perioperative Medication in Adult Cardiac Surgery”,2 which address significant novel advancements in the pharmacological management of adult patients undergoing various types of cardiac surgery, including open-heart surgery (coronary and non-coronary) and transcatheter aortic valve implantation. These guidelines comprise several drug classes and provide recommendations on their use, discontinuation and/or (re)introduction at the different phases surrounding elective, urgent or emergent cardiac interventions: early before, during, and after the operation, both short- and long-term. A substantial portion of the document focuses on antithrombotic agents, and several novel aspects and approaches warrant attention....

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Milojevic M, Freemantle N, Hayanga JWA, et al. Harmonizing guidelines and other clinical practice documents: a joint comprehensive methodology manual by the American Association for Thoracic Surgery (AATS), European Association for Cardio-Thoracic Surgery (EACTS), European Society of Thoracic Surgeons (ESTS), and Society of Thoracic Surgeons (STS). Ann Thorac Surg 2025;119:83-100. DOI: https://doi.org/10.1016/j.athoracsur.2024.09.023
Jeppsson A, Rocca B, Hansson EC, et al. 2024 EACTS Guidelines on perioperative medication in adult cardiac surgery. Eur J Cardiothorac Surg 2024;67:ezae355.
Milling Jr TJ, Middeldorp S, Xu L, et al. Final study report of andexanet alfa for major bleeding with factor Xa inhibitors. Circulation 2023;147:1026-38. DOI: https://doi.org/10.1161/CIRCULATIONAHA.121.057844

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2024 EACTS guidelines on perioperative medication in adult cardiac surgery: embracing precision medicine driven by strong evidence-based methodology. (2025). Bleeding, Thrombosis and Vascular Biology, 4(2). https://doi.org/10.4081/btvb.2025.178
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