Optimizing Antithrombotic Strategies in Patients with Concomitant Indications for Warfarin Undergoing Coronary Artery Stenting

The current standard in coronary artery stenting is dual antiplatelet therapy with aspirin and clopidogrel, with the duration of therapy primarily based on the use of bare metal or drug-eluting stents. The expanding patient population in whom oral anticoagulation and dual antiplatelet therapy may be indicated poses unique challenges in navigating the delicate balance between the efficacy of these therapies and bleeding risk. Although limited data exist, meaningful recommendations can be made involving individualization of these and other therapies (such as cilostazol) based on the perceived risk of thrombotic stent complications, indication for oral anticoagulant therapy, and bleeding risk.