Triple therapy in patients with atrial fibrillation and acute coronary syndrome or percutaneous coronary intervention/stenting.

Abstract

Patients with atrial fibrillation (AF) and acute coronary syndrome (ACS) are at high risk of stroke, recurrent coronary ischemic events, and cardiovascular mortality. The composition of antithrombotic therapy including an oral anticoagulant and antiplatelet drug(s) should be tailored according to the individual patient's risk profile, to reduce the bleeding risk and maintain antithrombotic effect. There is no single antithrombotic treatment regimen that would fit to all patients with AF and ACS. However, available data promote the use of full-dose direct oral anticoagulants (DOACs) (dabigatran 150 mg twice daily or apixaban 5 mg twice daily) or rivaroxaban 15 mg once daily in patients with AF and ACS or percutaneous coronary intervention (PCI). For many patients, a DOAC plus P2Y12 inhibitor early after ACS and/or PCI would be optimal, whereas a longer course of triple therapy should be used in patients at high thrombotic risk.

• Authors: Monika Kozieł, Tatjana S Potpara, Gregory Y H Lip
• Journal: Research and practice in thrombosis and haemostasis (Res Pract Thromb Haemost) Vol. 4 Issue 3 Pg. 357-365 (Mar 2020) ISSN: 2475-0379 [Electronic] United States
• PMID: 32211570 (Publication Type: Journal Article)
• Copyright: © 2020 The Authors. Research and Practice in Thrombosis and Haemostasis published by Wiley Periodicals, Inc on behalf of International Society on Thrombosis and Haemostasis.