Triple Antithrombotic Therapy for Patients with Atrial Fibrillation Undergoing Percutaneous Coronary Intervention.

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.

journal_name

Prog Cardiovasc Dis

authors

Kerneis M,Talib U,Nafee T,Daaboul Y,Pahlavani S,Pitliya A,Furqan MM,Datta S,Kazmi HA,Younes A,Gibson CM

doi

10.1016/j.pcad.2018.01.008

subject

Has Abstract

pub_date

2018-01-01 00:00:00

pages

524-530

issue

4-5

eissn

0033-0620

issn

1873-1740

pii

S0033-0620(18)30028-8

journal_volume

60

pub_type

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