Abstract
The optimal antithrombotic treatment regimen for patients with atrial fibrillation undergoing percutaneous coronary intervention with stent implantation represents a challenge in clinical practice. In 2016, an updated opinion of selected experts from the United States and Canada on the treatment of patients with atrial fibrillation undergoing percutaneous coronary intervention was reported. After the 2016 North American consensus statement on the management of antithrombotic therapy in patients with atrial fibrillation undergoing percutaneous coronary intervention, results of pivotal clinical trials assessing the type of oral anticoagulant agent and the duration of antiplatelet treatment have been published. On the basis of these results, this focused update on the antithrombotic management of patients with atrial fibrillation undergoing percutaneous coronary intervention recommends that a non-vitamin K antagonist oral anticoagulant be preferred over a vitamin K antagonist as the oral anticoagulant of choice. Moreover, a double-therapy regimen (oral anticoagulant plus single antiplatelet therapy with a P2Y12 inhibitor) by the time of hospital discharge should be considered for most patients, whereas extending the use of aspirin beyond hospital discharge (ie, triple therapy) should be considered only for selected patients at high ischemic/ thrombotic and low bleeding risks and for a limited period of time. The present document provides a focused updated on the rationale for the new expert consensus-derived recommendations on the antithrombotic management of patients with atrial fibrillation treated with oral anticoagulation undergoing percutaneous coronary intervention.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 527-536 |
| Number of pages | 10 |
| Journal | Circulation |
| Volume | 138 |
| Issue number | 5 |
| DOIs | |
| State | Published - Jan 1 2018 |
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Keywords
- Anticoagulants
- Atrial fibrillation
- Platelet aggregation inhibitors
- Stents
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Physiology (medical)
Cite this
Antithrombotic therapy in patients with atrial fibrillation treated with oral anticoagulation undergoing percutaneous coronary intervention : A North American perspective-2018 update. / Angiolillo, Dominick J.; Goodman, Shaun G.; Bhatt, Deepak L.; Eikelboom, John W.; Price, Matthew J.; Moliterno, David J.; Cannon, Christopher P.; Tanguay, Jean Francois; Granger, Christopher B.; Mauri, Laura; Holmes, David; Gibson, C. Michael; Faxon, David P.
In: Circulation, Vol. 138, No. 5, 01.01.2018, p. 527-536.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Antithrombotic therapy in patients with atrial fibrillation treated with oral anticoagulation undergoing percutaneous coronary intervention
T2 - A North American perspective-2018 update
AU - Angiolillo, Dominick J.
AU - Goodman, Shaun G.
AU - Bhatt, Deepak L.
AU - Eikelboom, John W.
AU - Price, Matthew J.
AU - Moliterno, David J.
AU - Cannon, Christopher P.
AU - Tanguay, Jean Francois
AU - Granger, Christopher B.
AU - Mauri, Laura
AU - Holmes, David
AU - Gibson, C. Michael
AU - Faxon, David P.
PY - 2018/1/1
Y1 - 2018/1/1
N2 - The optimal antithrombotic treatment regimen for patients with atrial fibrillation undergoing percutaneous coronary intervention with stent implantation represents a challenge in clinical practice. In 2016, an updated opinion of selected experts from the United States and Canada on the treatment of patients with atrial fibrillation undergoing percutaneous coronary intervention was reported. After the 2016 North American consensus statement on the management of antithrombotic therapy in patients with atrial fibrillation undergoing percutaneous coronary intervention, results of pivotal clinical trials assessing the type of oral anticoagulant agent and the duration of antiplatelet treatment have been published. On the basis of these results, this focused update on the antithrombotic management of patients with atrial fibrillation undergoing percutaneous coronary intervention recommends that a non-vitamin K antagonist oral anticoagulant be preferred over a vitamin K antagonist as the oral anticoagulant of choice. Moreover, a double-therapy regimen (oral anticoagulant plus single antiplatelet therapy with a P2Y12 inhibitor) by the time of hospital discharge should be considered for most patients, whereas extending the use of aspirin beyond hospital discharge (ie, triple therapy) should be considered only for selected patients at high ischemic/ thrombotic and low bleeding risks and for a limited period of time. The present document provides a focused updated on the rationale for the new expert consensus-derived recommendations on the antithrombotic management of patients with atrial fibrillation treated with oral anticoagulation undergoing percutaneous coronary intervention.
AB - The optimal antithrombotic treatment regimen for patients with atrial fibrillation undergoing percutaneous coronary intervention with stent implantation represents a challenge in clinical practice. In 2016, an updated opinion of selected experts from the United States and Canada on the treatment of patients with atrial fibrillation undergoing percutaneous coronary intervention was reported. After the 2016 North American consensus statement on the management of antithrombotic therapy in patients with atrial fibrillation undergoing percutaneous coronary intervention, results of pivotal clinical trials assessing the type of oral anticoagulant agent and the duration of antiplatelet treatment have been published. On the basis of these results, this focused update on the antithrombotic management of patients with atrial fibrillation undergoing percutaneous coronary intervention recommends that a non-vitamin K antagonist oral anticoagulant be preferred over a vitamin K antagonist as the oral anticoagulant of choice. Moreover, a double-therapy regimen (oral anticoagulant plus single antiplatelet therapy with a P2Y12 inhibitor) by the time of hospital discharge should be considered for most patients, whereas extending the use of aspirin beyond hospital discharge (ie, triple therapy) should be considered only for selected patients at high ischemic/ thrombotic and low bleeding risks and for a limited period of time. The present document provides a focused updated on the rationale for the new expert consensus-derived recommendations on the antithrombotic management of patients with atrial fibrillation treated with oral anticoagulation undergoing percutaneous coronary intervention.
KW - Anticoagulants
KW - Atrial fibrillation
KW - Platelet aggregation inhibitors
KW - Stents
UR - http://www.scopus.com/inward/record.url?scp=85050103367&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85050103367&partnerID=8YFLogxK
U2 - 10.1161/CIRCULATIONAHA.118.034722
DO - 10.1161/CIRCULATIONAHA.118.034722
M3 - Article
C2 - 30571525
AN - SCOPUS:85050103367
VL - 138
SP - 527
EP - 536
JO - Circulation
JF - Circulation
SN - 0009-7322
IS - 5
ER -