Patients with atrial fibrillation undergoing percutaneous coronary intervention. Current concepts and concerns: part I

Q: What is the clinical evidence from this study?

Study design: Review. Population: Atrial fibrillation and coronary artery disease undergoing percutaneous coronary intervention. Intervention: Triple antithrombotic therapy vs. Dual antiplatelet therapy or oral anticoagulation plus single antiplatelet therapy.

Mikhail S. Dzeshka; Richard A. Brown; Gregory Y.H. Lip

doi:10.20452/pamw.2650

December 23, 2015Polskie Archiwum Medycyny WewnętrznejOpen Access

Patients with atrial fibrillation undergoing percutaneous coronary intervention. Current concepts and concerns: part I

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Key result

Triple antithrombotic therapy is often warranted to prevent thrombotic and embolic events in patients with atrial fibrillation undergoing percutaneous coronary intervention, despite increased bleeding risk.

Why the study?

What is the optimal antithrombotic strategy to balance ischemic and bleeding risks in patients with atrial fibrillation undergoing percutaneous coronary intervention?

Structured PICO

What is the optimal antithrombotic strategy to balance ischemic and bleeding risks in patients with atrial fibrillation undergoing percutaneous coronary intervention?

P

Population

Patients with atrial fibrillation (AF) and coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI)

I

Intervention

Triple antithrombotic therapy (oral anticoagulation plus dual antiplatelet therapy) or oral anticoagulation plus single antiplatelet therapy

Limitations

Much of the current guidance comes from observational data.
Lack of large randomized trials testing various combinations of antithrombotic therapy.
Much of the current guidance comes from observational data
Lack of large, adequately powered randomized clinical trials testing various combinations of antithrombotic therapy

Implication

In patients with atrial fibrillation undergoing PCI, triple antithrombotic therapy is necessary to prevent ischemic events but increases bleeding risk, highlighting the need for careful risk stratification and minimized duration of triple therapy.

Abstract

ARTICLE Patients with atrial fibrillation undergoing percutaneous coronary intervention...

Discussion

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Cite This Study

Dzeshka et al. (2015) conducted a review in Atrial fibrillation and coronary artery disease undergoing percutaneous coronary intervention. Triple antithrombotic therapy vs. Dual antiplatelet therapy or oral anticoagulation plus single antiplatelet therapy was evaluated. Triple antithrombotic therapy is often warranted to prevent thrombotic and embolic events in patients with atrial fibrillation undergoing percutaneous coronary intervention, despite increased bleeding risk.

synapsesocial.com/papers/6a203e4824cb4701b18fd739 https://doi.org/10.20452/pamw.2650