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Antithrombotic Management in AF Patients Following Percutaneous Coronary Intervention: A European Perspective

AF is a highly prevalent disease, often requiring long-term oral anticoagulation to prevent stroke or systemic embolism. Coronary artery disease, which is common among AF patients, is often referred for myocardial revascularisation by percutaneous coronary intervention (PCI), which requires dual ant...

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Detalles Bibliográficos
Autores principales: Greco, Antonio, Laudani, Claudio, Rochira, Carla, Capodanno, Davide
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Radcliffe Cardiology 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10433110/
https://www.ncbi.nlm.nih.gov/pubmed/37601736
http://dx.doi.org/10.15420/icr.2021.30
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author Greco, Antonio
Laudani, Claudio
Rochira, Carla
Capodanno, Davide
author_facet Greco, Antonio
Laudani, Claudio
Rochira, Carla
Capodanno, Davide
author_sort Greco, Antonio
collection PubMed
description AF is a highly prevalent disease, often requiring long-term oral anticoagulation to prevent stroke or systemic embolism. Coronary artery disease, which is common among AF patients, is often referred for myocardial revascularisation by percutaneous coronary intervention (PCI), which requires dual antiplatelet therapy to minimise the risk of stent-related complications. The overlap of AF and PCI is a clinical conundrum, especially in the early post-procedural period, when both long-term oral anticoagulation and dual antiplatelet therapy are theoretically indicated as a triple antithrombotic therapy. However, stacking drugs is not a desirable option because of the increased bleeding risk. Several strategies have been investigated to mitigate this concern, including shortening triple antithrombotic therapy duration and switching to a dual antithrombotic regimen. This review analyses the mechanisms underlying thrombotic complications in AF-PCI, summarises evidence surrounding antithrombotic therapy regimens and reports and comments on the latest European guidelines.
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spelling pubmed-104331102023-08-18 Antithrombotic Management in AF Patients Following Percutaneous Coronary Intervention: A European Perspective Greco, Antonio Laudani, Claudio Rochira, Carla Capodanno, Davide Interv Cardiol Coronary AF is a highly prevalent disease, often requiring long-term oral anticoagulation to prevent stroke or systemic embolism. Coronary artery disease, which is common among AF patients, is often referred for myocardial revascularisation by percutaneous coronary intervention (PCI), which requires dual antiplatelet therapy to minimise the risk of stent-related complications. The overlap of AF and PCI is a clinical conundrum, especially in the early post-procedural period, when both long-term oral anticoagulation and dual antiplatelet therapy are theoretically indicated as a triple antithrombotic therapy. However, stacking drugs is not a desirable option because of the increased bleeding risk. Several strategies have been investigated to mitigate this concern, including shortening triple antithrombotic therapy duration and switching to a dual antithrombotic regimen. This review analyses the mechanisms underlying thrombotic complications in AF-PCI, summarises evidence surrounding antithrombotic therapy regimens and reports and comments on the latest European guidelines. Radcliffe Cardiology 2023-02-17 /pmc/articles/PMC10433110/ /pubmed/37601736 http://dx.doi.org/10.15420/icr.2021.30 Text en Copyright © The Author(s), 2023. Published by Radcliffe Group Ltd. 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
Greco, Antonio
Laudani, Claudio
Rochira, Carla
Capodanno, Davide
Antithrombotic Management in AF Patients Following Percutaneous Coronary Intervention: A European Perspective
title Antithrombotic Management in AF Patients Following Percutaneous Coronary Intervention: A European Perspective
title_full Antithrombotic Management in AF Patients Following Percutaneous Coronary Intervention: A European Perspective
title_fullStr Antithrombotic Management in AF Patients Following Percutaneous Coronary Intervention: A European Perspective
title_full_unstemmed Antithrombotic Management in AF Patients Following Percutaneous Coronary Intervention: A European Perspective
title_short Antithrombotic Management in AF Patients Following Percutaneous Coronary Intervention: A European Perspective
title_sort antithrombotic management in af patients following percutaneous coronary intervention: a european perspective
topic Coronary
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10433110/
https://www.ncbi.nlm.nih.gov/pubmed/37601736
http://dx.doi.org/10.15420/icr.2021.30
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