Key result
Triple therapy with aspirin, prasugrel, and rivaroxaban linked to severe recurrent epistaxis post-PCI.
Why the study?
The risks of triple oral anticoagulation therapy versus dual antiplatelet therapy do not address all current medication combinations, including rivaroxaban, prasugrel, and aspirin.
Case Report (n=1)
Case of recurrent epistaxis on unstudied triple regimen; hypothesis-generating and leaves open optimal antithrombotic choices in AF with recent stents.
Hemorrhagic side effects are the bane of oral anticoagulation. Despite careful selection of medications and close monitoring, some adverse events are unavoidable. The available literature about the risks of triple oral anticoagulation therapy versus dual antiplatelet therapy does not address all of the medication combinations currently available. This report describes a patient with atrial fibrillation and recent stent placement who developed severe, recurrent epistaxis on aspirin, prosugrel, and rivaroxaban. We believe this is the first case report of severe bleeding with this combination, and it may help provide insights into the risk for other patients.
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Gruenebaum et al. (2014) conducted a case report in Atrial fibrillation and recent stent placement (n=1). Triple therapy (aspirin, prasugrel, and rivaroxaban) was evaluated on Severe, recurrent epistaxis. Triple therapy with aspirin, prasugrel, and rivaroxaban was associated with severe, recurrent epistaxis in a patient with atrial fibrillation and recent stent placement.
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