Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
8675257 | Progress in Cardiovascular Diseases | 2018 | 7 Pages |
Abstract
Dual antiplatelet therapy (DAPT) has been the cornerstone of antithrombotic management for patients undergoing percutaneous coronary intervention (PCI). However, approximately 10% of these patients have concomitant atrial fibrillation (AF) and require chronic oral anticoagulant (OAC) in addition to DAPT. This traditional “triple therapy” has been associated with a three to four-fold increased risk of bleeding. The safety of non-vitamin K OAC (NOAC)-based strategies, using a NOAC plus a P2Y12 inhibitor, has been compared to vitamin K antagonist (VKA)-based triple therapy in the PIONEER AF-PCI and REDUAL PCI randomized trials, both of which have demonstrated that NOAC-based strategies are safer and provide an attractive alternative to VKA-based triple therapy among AF patients who undergo PCI. This article reviews the rationale, evidence, and recent evaluation of triple antithrombotic therapy among AF patients undergoing PCI.
Keywords
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Authors
Mathieu Kerneis, Usama Talib, Tarek Nafee, Yazan Daaboul, Seyedmahdi Pahlavani, Anmol Pitliya, M.M. Furqan, Sudarshana Datta, Hassan A. Kazmi, Ahmed Younes, C. Michael Gibson,