Abstract
Selecting anticoagulation therapy for patients with atrial fibrillation and coronary artery disease has always been challenging for physicians. The treatment modalities have evolved with time. Oral anticoagulation with warfarin was used in the initial era of stenting to prevent stent thrombosis, and dual antiplatelet therapy is the current recommendation. Triple anticoagulation therapy, i.e., aspirin, P2Y12 inhibitor, and oral anticoagulation, is associated with higher bleeding episodes and mortality compared to the combination of an anticoagulant and a P2Y12 inhibitor.
Highlights
BackgroundIn patients who need oral anticoagulation and antiplatelet therapy, it is clinically challenging to balance the benefit and risks involved with aggressive antithrombotic treatment
I.e., aspirin, P2Y12 inhibitor, and oral anticoagulation, is associated with higher bleeding episodes and mortality compared to the combination of an anticoagulant and a P2Y12 inhibitor
direct-acting oral anticoagulants (DOACs)-based double therapy decreases the bleeding risk compared with triple therapy, for all bleeding definitions
Summary
In patients who need oral anticoagulation and antiplatelet therapy, it is clinically challenging to balance the benefit and risks involved with aggressive antithrombotic treatment. Optimum treatment preferences for AF patients who undergo percutaneous coronary intervention (PCI) have been controversial. Dual antiplatelet therapy (DAPT), i.e., aspirin plus P2Y12 inhibitors, is used for secondary prevention of coronary events and protection against stent thrombosis but does not provide complete protection against stroke in AF [3,4,5]. Ten percent of patients who undergo PCI have AF, and others have VTE [6]. Before 2016, it was common to use triple therapy post-PCI in patients with AF or VTE. Before we go into the details of different clinical trials, we should assess the individual patient risk for bleeding and thrombosis. OAC with clopidogrel 75 mg/day (double therapy) OAC with clopidogrel 75 mg/day plus ASA 80-100 mg/day (triple therapy)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
