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Is It Really Safe to Discontinue Antiplatelet Therapy 12 Months After Percutaneous Coronary Intervention in Patients with Atrial Fibrillation?

The prevalence of AF in patients with coronary artery disease is high. The guidelines from many professional groups, including the European Society of Cardiology, American College of Cardiology/American Heart Association and Heart Rhythm Society, recommend a maximum duration of 12 months of combinat...

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Detalles Bibliográficos
Autores principales: Abdulrahman, Balen, Jabbour, Richard J, Curzen, Nick
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Radcliffe Cardiology 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10331563/
https://www.ncbi.nlm.nih.gov/pubmed/37435601
http://dx.doi.org/10.15420/icr.2022.40
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author Abdulrahman, Balen
Jabbour, Richard J
Curzen, Nick
author_facet Abdulrahman, Balen
Jabbour, Richard J
Curzen, Nick
author_sort Abdulrahman, Balen
collection PubMed
description The prevalence of AF in patients with coronary artery disease is high. The guidelines from many professional groups, including the European Society of Cardiology, American College of Cardiology/American Heart Association and Heart Rhythm Society, recommend a maximum duration of 12 months of combination single antiplatelet and anticoagulation therapy in patients who undergo percutaneous coronary intervention and who have concurrent AF, followed by anticoagulation alone beyond 1 year. However, the evidence that anticoagulation alone without antiplatelet therapy adequately reduces the well-documented attritional risk of stent thrombosis after coronary stent implantation is relatively sparse, particularly given that very late stent thrombosis (>1 year from stent implantation) is the commonest type. By contrast, the elevated risk of bleeding from combined anticoagulation and antiplatelet therapy is clinically important. The aim of this review is to assess the evidence for long-term anticoagulation alone without antiplatelet therapy 1 year post-percutaneous coronary intervention in patients with AF.
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spelling pubmed-103315632023-07-11 Is It Really Safe to Discontinue Antiplatelet Therapy 12 Months After Percutaneous Coronary Intervention in Patients with Atrial Fibrillation? Abdulrahman, Balen Jabbour, Richard J Curzen, Nick Interv Cardiol Coronary The prevalence of AF in patients with coronary artery disease is high. The guidelines from many professional groups, including the European Society of Cardiology, American College of Cardiology/American Heart Association and Heart Rhythm Society, recommend a maximum duration of 12 months of combination single antiplatelet and anticoagulation therapy in patients who undergo percutaneous coronary intervention and who have concurrent AF, followed by anticoagulation alone beyond 1 year. However, the evidence that anticoagulation alone without antiplatelet therapy adequately reduces the well-documented attritional risk of stent thrombosis after coronary stent implantation is relatively sparse, particularly given that very late stent thrombosis (>1 year from stent implantation) is the commonest type. By contrast, the elevated risk of bleeding from combined anticoagulation and antiplatelet therapy is clinically important. The aim of this review is to assess the evidence for long-term anticoagulation alone without antiplatelet therapy 1 year post-percutaneous coronary intervention in patients with AF. Radcliffe Cardiology 2023-06-13 /pmc/articles/PMC10331563/ /pubmed/37435601 http://dx.doi.org/10.15420/icr.2022.40 Text en Copyright © 2023, Radcliffe Cardiology https://creativecommons.org/licenses/by-nc/4.0/This work is open access under the CC-BY-NC 4.0 License which allows users to copy, redistribute and make derivative works for non-commercial purposes, provided the original work is cited correctly.
spellingShingle Coronary
Abdulrahman, Balen
Jabbour, Richard J
Curzen, Nick
Is It Really Safe to Discontinue Antiplatelet Therapy 12 Months After Percutaneous Coronary Intervention in Patients with Atrial Fibrillation?
title Is It Really Safe to Discontinue Antiplatelet Therapy 12 Months After Percutaneous Coronary Intervention in Patients with Atrial Fibrillation?
title_full Is It Really Safe to Discontinue Antiplatelet Therapy 12 Months After Percutaneous Coronary Intervention in Patients with Atrial Fibrillation?
title_fullStr Is It Really Safe to Discontinue Antiplatelet Therapy 12 Months After Percutaneous Coronary Intervention in Patients with Atrial Fibrillation?
title_full_unstemmed Is It Really Safe to Discontinue Antiplatelet Therapy 12 Months After Percutaneous Coronary Intervention in Patients with Atrial Fibrillation?
title_short Is It Really Safe to Discontinue Antiplatelet Therapy 12 Months After Percutaneous Coronary Intervention in Patients with Atrial Fibrillation?
title_sort is it really safe to discontinue antiplatelet therapy 12 months after percutaneous coronary intervention in patients with atrial fibrillation?
topic Coronary
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10331563/
https://www.ncbi.nlm.nih.gov/pubmed/37435601
http://dx.doi.org/10.15420/icr.2022.40
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