Triple Oral Antithrombotic Therapy in Atrial Fibrillation and Coronary Artery Stenting
Key result
Triple oral antithrombotic therapy significantly increases bleeding risk in patients with atrial fibrillation after coronary stenting, with current care guided largely by expert opinion.
Why the study?
What are the risks and benefits of triple oral antithrombotic therapy in patients with atrial fibrillation after coronary artery stenting?
Population
Patients with atrial fibrillation affected by an acute coronary syndrome after coronary artery stenting
Design
Review
Authors
Discussion
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Member takes
Implication
May guide regimen selection in AF with ACS post-stent; leaves open confirmation by randomized trials.
Key Points
- This review summarizes the risks and benefits of triple oral antithrombotic therapy in atrial fibrillation patients following coronary artery stenting.
- Review of evidence on triple oral antithrombotic therapy
- Discussion of clinical risk scores related to stroke and bleeding
- Evaluation of current expert opinions and practices
- Triple therapy significantly increases bleeding risk compared to dual therapy.
- Variability in clinician practices indicates a lack of consensus on optimal therapy combination.
- Further evidence is necessary to define best practices for combining anticoagulants and antiplatelet agents.
Structured PICO
What are the risks and benefits of triple oral antithrombotic therapy in patients with atrial fibrillation after coronary artery stenting?
P
Population
Patients with atrial fibrillation affected by an acute coronary syndrome after coronary artery stenting
I
Intervention
Triple oral antithrombotic therapy (oral anticoagulation and dual antiplatelet therapy with aspirin and a P2Y12 adenosine diphosphate receptor inhibitor)
This review highlights the increased bleeding risk associated with triple antithrombotic therapy in patients with atrial fibrillation undergoing coronary stenting and discusses the use of clinical risk scores to guide individualized treatment.
Limitations
- Lack of evidence on the proper combination and duration of anticoagulant and antiplatelet agents
Cite This Study
Reed et al. (2013) conducted a review in Atrial fibrillation and acute coronary syndrome after coronary artery stenting. Triple oral antithrombotic therapy was evaluated. Triple oral antithrombotic therapy significantly increases bleeding risk in patients with atrial fibrillation after coronary stenting, with current care guided largely by expert opinion.