Key result
Continuation of triple anticoagulation therapy was associated with a significantly higher risk of major bleeding compared to early termination of any component (18.6% vs. 4.2%, p=0.008).
Why the study?
Does premature discontinuation of any component of triple anticoagulation therapy reduce bleeding without increasing thromboembolic events in patients with atrial fibrillation undergoing PCI?
Observational (n=136)
No
Does premature discontinuation of any component of triple anticoagulation therapy reduce bleeding without increasing thromboembolic events in patients with atrial fibrillation undergoing PCI?
Absolute Event Rate: 18.6% vs 4.2%
p-value: p=0.008
In real-world practice, triple therapy in AF patients undergoing PCI is associated with high bleeding rates, and early discontinuation of a component reduces major bleeding without significantly increasing thromboembolic risk.
Supports early de-escalation of triple therapy to curb bleeding; leaves open optimal regimens in prospective trials.
INTRODUCTION: Triple anticoagulation therapy (TT), comprising dual antiplatelet therapy (DAPT) and oral anticoagulation (OAC), is essential in atrial fibrillation (AF) patients after percutaneous coronary intervention (PCI), but it increases the bleeding risk. AIM: To assess TT models, in- and out-hospital bleeding and thromboembolic complications, and TT alterations. MATERIAL AND METHODS: During 12 months, consecutive AF post-PCI patients were scheduled for TT. Alterations in TT and thromboembolic events (death, myocardial infarction, ischemic stroke, in-stent thrombosis, peripheral embolization) were recorded. Major, non-major and minor bleeding episodes were assessed. RESULTS: = 0.89). CONCLUSIONS: Our study indicates that TT is associated with high mortality and bleeding rates in a relatively short period of time. Discontinuation of any TT drug did not increase the thromboembolic event rate, while it was associated with reduced risk of major bleeding.
No takes yet. Share an insight, caveat, or question.
Bogacki et al. (2016) conducted an observational in Atrial fibrillation undergoing percutaneous coronary intervention (n=136). Triple anticoagulation therapy (TT) vs. Early termination of any TT component was evaluated on Major bleeding (p=0.008). Continuation of triple anticoagulation therapy was associated with a significantly higher risk of major bleeding compared to early termination of any component (18.6% vs. 4.2%, p=0.008).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: