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Oral Anticoagulants With Dual Antiplatelet Therapy Versus Clopidogrel in Patients After Percutaneous Coronary Intervention: A Meta-Analysis
Conclusions: In patients who are on OAC with vitamin K antagonist and underwent percutaneous coronary intervention, no significant differences were found in mortality, ischemic, and hemorrhagic complications between the patients treated with TT and DT. Thus, tailored treatment based on individual thromboembolic and bleeding risk might be the most reasonable approach in these patients.
Source: American Journal of Therapeutics - December 29, 2018 Category: Drugs & Pharmacology Tags: Reviews Source Type: research

Non-vitamin K antagonist oral anticoagulants (NOACs) in the treatment of coronary and peripheral atherosclerosis. Expert Consensus.
Abstract Oral anticoagulants (OAC) are widely used for prevention of systemic thromboembolism, including the reduction of the risk of stroke in patients with atrial fibrillation (AF) and prosthetic heart valves. There is also an increasing population of patients who require not only OACs, but also double antiplatelet therapy (DAPT). A typical example is a patient with AF and stable coronary artery disease or acute coronary syndrome (ACS), treated by percutaneous coronary intervention (PCI). In recent years, with the introduction of NOACs, triple or dual therapy has become safer. Regardless of these indications for...
Source: Polish Heart Journal - February 25, 2019 Category: Cardiology Authors: Witkowski A, Barylski M, Filipiak KJ, Gierlotka M, Legutko J, Lesiak M, Stępińska J, Wojakowski W Tags: Kardiol Pol Source Type: research

A drug safety evaluation of apixaban for the treatment of atrial fibrillation, acute coronary syndrome and percutaneous coronary intervention.
Authors: Gumprecht J, Domek M, Lip GY Abstract Introduction: The non-vitamin K antagonist oral anticoagulants (NOACs) are changing the landscape for stroke prevention in atrial fibrillation (AF) and prevention or treatment of venous thromboembolism (VTE). In patients with AF and concomitant acute coronary syndrome (ACS), the treatment regimen of combined NOACs and P2Y12 inhibitors is gaining popularity. Areas covered: The authors conducted a review of studies published in the last 10 years regarding safety evaluation and effectiveness of apixaban for the treatment of AF and ACS, both alone and in combination with d...
Source: Expert Opinion on Drug Safety - October 4, 2019 Category: Drugs & Pharmacology Tags: Expert Opin Drug Saf Source Type: research

Anti-thrombotic strategies in patients with atrial fibrillation undergoing PCI
AbstractTriple anti-thrombotic therapy combining oral anticoagulation and dual anti-platelet therapy following percutaneous coronary intervention in patients with atrial fibrillation was considered as standard and recommended by guidelines. While bleeding risk is considerable with that approach, data for efficacy are scare. Several trials assessed the possibility of reducing anti-thrombotic treatment by mainly shortening the exposure to acetylsalicylic acid. Dropping one of the anti-platelet components might increase the risk of stent thrombosis, myocardial infarction or stroke. Despite that fear, the recent trials ’ pri...
Source: Clinical Research in Cardiology - July 20, 2020 Category: Cardiology Source Type: research

Antithrombotic Therapy and Outcomes of Patients With New-Onset Transient Atrial Fibrillation After ST-Segment Elevation Myocardial Infarction
Conclusions: There is not a widely accepted treatment algorithm in patients with STEMI who complicated with new-onset AF in clinical guidelines. The current study indicated that transient form of new-onset AF might not require long-term VKA. Besides, addition of VKA to DAPT therapy may increase the rates of major and minor bleeding.
Source: American Journal of Therapeutics - December 31, 2020 Category: Drugs & Pharmacology Tags: Original Investigations Source Type: research

Inhibition of Platelet Aggregation After Coronary Stenting in Patients Receiving Oral Anticoagulation
CONCLUSION: After coronary stent implantation, dual therapy with a NOAC and a P2Y12 inhibitor is recommended, subsequent to triple therapy given only during the peri-interventional period.PMID:33637173 | DOI:10.3238/arztebl.m2021.0150
Source: Deutsches Arzteblatt International - February 27, 2021 Category: General Medicine Authors: Conrad Genz Ruediger C Braun-Dullaeus Source Type: research

Vitamin K antagonists with or without long ‐term antiplatelet therapy in outpatients with stable coronary artery disease and atrial fibrillation: Association with ischemic and bleeding events
ConclusionsIn this observational analysis, the use of APT in addition to OAC in patients with stable CAD and AF was not associated with lower risk of ischemic events but possibly with higher bleeding rates. Randomized trials are necessary to determine the optimal long‐term antithrombotic strategy.
Source: Clinical Cardiology - July 10, 2017 Category: Cardiology Authors: Gilles Lemesle, Gregory Ducrocq, Yedid Elbez, Eric Van Belle, Shinya Goto, Christopher P. Cannon, Christophe Bauters, Deepak L. Bhatt, Philippe Gabriel Steg, Tags: CLINICAL INVESTIGATIONS Source Type: research

Optimal antithrombotic treatment of patients with atrial fibrillation undergoing percutaneous coronary intervention: triple therapy is too much!
Abstract Patients with atrial fibrillation who undergo a coronary intervention are eligible for both anticoagulation and (dual) antiplatelet therapy ((D)APT). An optimal balance has to be found to reduce the thromboembolic risk (i.e. stroke, systemic embolism and myocardial infarction) and to minimise the increased risk of bleeding with concomitant use of an anticoagulant and (D)APT. Owing to a lack of evidence, the guideline recommendations are predominantly based on expert opinion. Current evidence indicates that the combination of a non-vitamin K oral anticoagulant (NOAC) and clopidogrel is safer than vitam...
Source: Netherlands Heart Journal - May 8, 2018 Category: Cardiology Authors: Jacobs MS, Tieleman RG Tags: Neth Heart J Source Type: research

Safety and efficacy of non-vitamin K oral anticoagulant for atrial fibrillation patients following percutaneous coronary intervention: A bivariate analysis of the PIONEER AF-PCI and RE-DUAL PCI trial
Conclusions A bivariate analysis that simultaneously characterizes both risk and benefit demonstrates that rivaroxaban- and dabigatran-based regimens were both favorable over VKA plus dual antiplatelet therapy among patients with AF undergoing PCI.
Source: American Heart Journal - June 13, 2018 Category: Cardiology Source Type: research

Safety and efficacy of non –vitamin K oral anticoagulant for atrial fibrillation patients after percutaneous coronary intervention: A bivariate analysis of the PIONEER AF-PCI and RE-DUAL PCI trial
Conclusions A bivariate analysis that simultaneously characterizes both risk and benefit demonstrates that riva- and dabi-based regimens were both favorable over VKA plus dual antiplatelet therapy among patients with atrial fibrillation undergoing PCI.
Source: American Heart Journal - July 4, 2018 Category: Cardiology Source Type: research

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