Open AccessAntithrombotic therapy in patients with atrial fibrillation and acute coronary syndrome and / or undergoing percutaneous coronary intervention
Author(s) -
M Mihajlović,
Milan Marinković,
Monika Kozieł,
Nebojša Mujović,
Gregory Y. H. Lip,
Tatjana Potpara
Publication year - 2020
Publication title -
kardiologia polska
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.527
H-Index - 34
eISSN - 1897-4279
pISSN - 0022-9032
DOI - 10.33963/kp.15428
Subject(s) - medicine , percutaneous coronary intervention , antithrombotic , acute coronary syndrome , conventional pci , aspirin , atrial fibrillation , vitamin k antagonist , cardiology , randomized controlled trial , p2y12 , warfarin , clopidogrel , myocardial infarction
The use of triple antithrombotic therapy (TAT) consisting of an oral anticoagulant (OAC), aspirin, and a P2Y12 inhibitor in patients with atrial fibrillation (AF) and acute coronary syndrome (ACS) and / or undergoing percutaneous coronary intervention (PCI) is associated with a high risk of bleeding. Recently, several randomized clinical trials tested the hypothesis as to whether dual antithrombotic therapy (DAT) regimens (consisting of an OAC and a single antiplatelet drug) may be safer in terms of bleeding events as compared with TAT. They also investigated the role of non-vitamin K antagonist oral anticoagulants (NOACs) as a part of DAT and TAT. The purpose of this review is to provide an overview of available evidence regarding the safety and efficacy of DAT compared with TAT regimens, international guidelines recommendations, knowledge gaps, and unmet needs in the management of patients with AF and ACS and / or undergoing PCI.