Triple, dual, and single antithrombotic therapy for patients with atrial fibrillation undergoing percutaneous coronary intervention

Cardiovasc Interv Ther. 2020 Jan;35(1):44-51. doi: 10.1007/s12928-019-00600-1. Epub 2019 Jul 8.

Abstract

In patients with atrial fibrillation (AF), concomitant coronary artery disease is often present, and vice versa. Although both AF and coronary artery disease need antithrombotic therapy to reduce ischemic events, optimal antithrombotic regimens for patients with AF undergoing percutaneous coronary intervention (PCI) remain unclear. Triple therapy, a combination of oral anticoagulant plus dual antiplatelet therapy with aspirin and P2Y12 inhibitor, has been used for patients with AF undergoing PCI as an initial antithrombotic strategy in the recent decade. However, triple therapy is well-known to induce severe bleeding events. Recently, several clinical trials have been published and guideline recommendations have been updated. This review article summarizes current evidence concerning antithrombotic therapy in patients with AF undergoing PCI.

Keywords: Antithrombotic therapy; Atrial fibrillation; Percutaneous coronary intervention.

Publication types

  • Review

MeSH terms

  • Anticoagulants / therapeutic use
  • Atrial Fibrillation / complications
  • Atrial Fibrillation / therapy*
  • Coronary Artery Disease / complications
  • Coronary Artery Disease / therapy*
  • Drug Therapy, Combination
  • Fibrinolytic Agents / therapeutic use*
  • Humans
  • Percutaneous Coronary Intervention / methods*
  • Platelet Aggregation Inhibitors / therapeutic use*
  • Treatment Outcome

Substances

  • Anticoagulants
  • Fibrinolytic Agents
  • Platelet Aggregation Inhibitors