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Title: | Management of Antithrombotic Therapy in Atrial Fibrillation Patients Undergoing PCI JACC State-of-the-Art Review | Authors: | Capodanno, Davide Huber, Kurt Mehran, Roxana Lip, Gregory Y. H. Faxon, David P. Granger, Christopher B. VRANCKX, Pascal Lopes, Renato D. Montalescot, Gilles Cannon, Christopher P. Ten Berg, Jurien Gersh, Bernard J. Bhatt, Deepak L. Angiolillo, Dominick J. |
Issue Date: | 2019 | Publisher: | ELSEVIER SCIENCE INC | Source: | JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 74(1), p. 83-99 | Abstract: | Most patients with atrial fibrillation (AF) and risk factors for stroke require oral anticoagulation (OAC) to decrease the risk of stroke or systemic embolism. This is now best achieved with direct oral anticoagulants that decrease the risk of intracranial bleeding compared with vitamin K antagonists. Of note, approximately 5% to 10% of patients undergoing percutaneous coronary intervention have AF, which complicates antithrombotic therapy in daily practice, because the guidelines recommend that these patients also receive dual antiplatelet therapy (DAPT) to reduce the risk of ischemic complications. However, combining OAC with DAPT, a strategy also known as triple antithrombotic therapy, is known to increase the risk of bleeding compared with the use of OAC or DAPT alone. Studies of direct oral anticoagulants are now emerging that show the favorable safety profile of double antithrombotic therapy with OAC and a P2Y(12) inhibitor in comparison with triple antithrombotic therapy including the use of vitamin K antagonists. The scope of this review is to provide an update on this topic as well as to discuss future directions in the management of antithrombotic therapy after percutaneous coronary intervention in AF patients requiring chronic OAC. (C) 2019 by the American College of Cardiology Foundation. | Notes: | [Capodanno, Davide] Univ Catania, AOU Policlin Vittorio Emanuele, Div Cardiol, Catania, Italy. [Huber, Kurt] Sigmund Freud Univ, Dept Med 3, Cardiol & Intens Care Med, Vienna, Austria. [Huber, Kurt] Sigmund Freud Univ, Fac Med, Vienna, Austria. [Mehran, Roxana] Icahn Sch Med Mt Sinai, Cardiovasc Inst, New York, NY 10029 USA. [Lip, Gregory Y. H.] Univ Liverpool, Liverpool Ctr Cardiovasc Sci, Liverpool, Merseyside, England. [Lip, Gregory Y. H.] Liverpool Heart & Chest Hosp, Liverpool, Merseyside, England. [Lip, Gregory Y. H.] Aalborg Univ, Dept Clin Med, Aalborg Thrombosis Res Unit, Aalborg, Denmark. [Faxon, David P.; Cannon, Christopher P.; Bhatt, Deepak L.] Harvard Med Sch, Brigham & Womens Hosp, Heart & Vasc Ctr, Boston, MA 02115 USA. [Granger, Christopher B.; Lopes, Renato D.] Duke Univ, Sch Med, Duke Clin Res Inst, Durham, NC USA. [Vranckx, Pascal] Univ Hasselt, Hartctr Hasselt, Dept Cardiol & Crit Care Med, Hasselt, Belgium. [Vranckx, Pascal] Univ Hasselt, Fac Med & Life Sci, Hasselt, Belgium. [Montalescot, Gilles] Montpellier Univ, Univ Nimes Hosp, Cardiol Dept, ACTION Study Grp, Nimes, France. [Ten Berg, Jurien] St Antonius Hosp, Dept Cardiol, Nieuwegein, Netherlands. [Gersh, Bernard J.] Mayo Clin, Coll Med, Rochester, MN USA. [Angiolillo, Dominick J.] Univ Florida, Coll Med, Div Cardiol, Jacksonville, FL USA. | Keywords: | atrial fibrillation; coronary stenting; oral anticoagulant; oral antiplatelet;atrial fibrillation; coronary stenting; oral anticoagulant; oral antiplatelet | Document URI: | http://hdl.handle.net/1942/29050 | ISSN: | 0735-1097 | e-ISSN: | 1558-3597 | DOI: | 10.1016/j.jacc.2019.05.016 | ISI #: | 000473259200013 | Rights: | 2019 by the American College of Cardiology Foundation. Published by Elsevier. | Category: | A1 | Type: | Journal Contribution | Validations: | ecoom 2020 |
Appears in Collections: | Research publications |
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