Key result
Triple antithrombotic therapy carries a higher risk of bleeding and death compared to double therapy with an oral anticoagulant and a P2Y12 inhibitor, without a significant increase in efficacy.
Why the study?
Selecting anticoagulation therapy for patients with atrial fibrillation and coronary artery disease has always been challenging for physicians, with evolving treatment modalities.
Does double antithrombotic therapy reduce bleeding compared to triple therapy in patients with atrial fibrillation undergoing PCI?
Does double antithrombotic therapy reduce bleeding compared to triple therapy in patients with atrial fibrillation undergoing PCI?
In patients with AF undergoing PCI, double therapy with an OAC and P2Y12 inhibitor reduces bleeding risk compared to triple therapy without significantly increasing ischemic events.
Triple therapy raises bleeding risk in AF-CAD; leaves open optimal regimen selection.
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.
No takes yet. Share an insight, caveat, or question.
Hussain et al. (2022) conducted a review in Atrial fibrillation and coronary artery disease requiring percutaneous coronary intervention. Triple antithrombotic therapy (oral anticoagulation, aspirin, and P2Y12 inhibitor) vs. Double antithrombotic therapy (oral anticoagulation and P2Y12 inhibitor) was evaluated. Triple antithrombotic therapy carries a higher risk of bleeding and death compared to double therapy with an oral anticoagulant and a P2Y12 inhibitor, without a significant increase in efficacy.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: