Antithrombotic therapy in patients with atrial fibrillation treated with oral anticoagulation undergoing percutaneous coronary intervention: A North American perspective-2018 update

Dominick J. Angiolillo, Shaun G. Goodman, Deepak L. Bhatt, John W. Eikelboom, Matthew J. Price, David J. Moliterno, Christopher P. Cannon, Jean Francois Tanguay, Christopher B. Granger, Laura Mauri, David Holmes, C. Michael Gibson, David P. Faxon

Research output: Contribution to journalArticle

60 Citations (Scopus)

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 languageEnglish (US)
Pages (from-to)527-536
Number of pages10
JournalCirculation
Volume138
Issue number5
DOIs
StatePublished - Jan 1 2018

Fingerprint

Percutaneous Coronary Intervention
Atrial Fibrillation
Anticoagulants
Therapeutics
Vitamin K
Expert Testimony
Aspirin
Canada
Stents
Clinical Trials
Hemorrhage

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 journalArticle

Angiolillo, DJ, Goodman, SG, Bhatt, DL, Eikelboom, JW, Price, MJ, Moliterno, DJ, Cannon, CP, Tanguay, JF, Granger, CB, Mauri, L, Holmes, D, Gibson, CM & Faxon, DP 2018, 'Antithrombotic therapy in patients with atrial fibrillation treated with oral anticoagulation undergoing percutaneous coronary intervention: A North American perspective-2018 update', Circulation, vol. 138, no. 5, pp. 527-536. https://doi.org/10.1161/CIRCULATIONAHA.118.034722
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. / Antithrombotic therapy in patients with atrial fibrillation treated with oral anticoagulation undergoing percutaneous coronary intervention : A North American perspective-2018 update. In: Circulation. 2018 ; Vol. 138, No. 5. pp. 527-536.
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