Antithrombotic Management of Atrial Fibrillation Patients Presenting with Coronary Artery Disease: A Consensus Document of the Chinese Society of Cardiology

Abstract

Abstract The coexistence of coronary artery disease (CAD) and atrial fibrillation (AF) is common in clinical practice. Patients with CAD require antiplatelet therapy to reduce the occurrence of myocardial ischemic events. However, patients with AF at high risk of thromboembolism require oral anticoagulants to reduce the occurrence of thromboembolic events such as stroke. In cases where CAD coexists with AF, the combined use of antiplatelet and anticoagulation therapy can effectively reduce the risk of ischemic and thromboembolic events but increase the risk of bleeding at the same time. The optimal antithrombotic regimen in patients with both CAD and AF has been controversial in clinical practice. In recent years, the expert consensuses on antithrombotic therapy in patients with AF presenting with acute coronary syndrome and/or undergoing percutaneous coronary intervention have been successively released in Europe and North America, and have been updated in a timely manner. In contrast, the guidelines on antithrombotic therapies in China are lacking. Based on published clinical evidence, this consensus incorporated relevant international and Chinese guidelines, consensuses, and expert recommendations, and addressed the issues encountered in the clinical practice of antithrombotic therapy in patients with AF and different types of CAD. The current guideline is of great significance to guide treatment in patients with both CAD and AF in China.