Why the study?
Management of antithrombotic therapy in patients with concomitant atrial fibrillation and coronary artery disease is challenging due to differing efficacy and safety profiles of oral anticoagulation and antiplatelet therapies.
This review summarizes the evidence and rationale for balancing oral anticoagulation and antiplatelet therapy in patients with both atrial fibrillation and coronary artery disease.
Answers are grounded in this paper and cite their sources.
Supports individualized antithrombotic regimens in AF with CAD; leaves open optimal strategies pending randomized trials.
Atrial fibrillation (AF) is a chronic progressive disease characterized by exacerbations and remissions. Up to 20–30% of patients with AF also have coronary artery disease (CAD). In patients with concomitant AF and CAD, the management of antithrombotic therapy is challenging. Oral anticoagulation (OAC) is indicated for the prevention of AF-related stroke and systemic embolism, whereas antiplatelet therapy is indicated for the prevention of coronary events. Each of these therapeutic avenues offers a relative efficacy benefit (e.g., dual antiplatelet therapy [DAPT] is more effective than OAC alone in reducing cardiovascular death, myocardial infarction, stent thrombosis, and ischemic coronary events in an ACS population), but with a relative compromise (e.g., DAPT is significantly inferior to OAC for the prevention of stroke/systemic embolism in an AF population at increased risk of AF-related stroke). The purpose of this review is to explore the current evidence and rationale for antithrombotic treatment strategies in patients with both AF and CAD.
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Andrade et al. (2018) conducted a review in Atrial fibrillation and coronary artery disease. Antithrombotic therapy was evaluated.
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