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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

Apixaban or Vitamin K Antagonists and Aspirin or Placebo According to Kidney Function in Patients with Atrial Fibrillation After Acute Coronary Syndrome or PCI: Insights from The AUGUSTUS Trial.
Conclusions: The safety and efficacy of apixaban was consistent irrespective of kidney function, as compared with warfarin, and in accordance with the overall trial results. The risk of bleeding with aspirin was consistently higher across all kidney function categories. Clinical Trial Registration: URL: https://www.clinicaltrials.gov Unique Identifier: NCT02415400. PMID: 33461308 [PubMed - as supplied by publisher]
Source: Circulation - January 19, 2021 Category: Cardiology Authors: Hijazi Z, Alexander JH, Li Z, Wojdyla DM, Mehran R, Granger CB, Parkhomenko A, Bahit MC, Windecker S, Aronson R, Berwanger O, Halvorsen S, de Waha-Thiele S, Sinnaeve P, Darius H, Storey RF, Lopes RD Tags: Circulation Source Type: research

Clinical risk predictors in atrial fibrillation patients following successful coronary stenting: ENTRUST-AF PCI sub-analysis
ConclusionAfter PCI in AF patients, increasing CHA2DS2-VASc score was associated with increased bleeding rates and CHA2DS2-VASc score ( ≥ 5) predicted the occurrence of stent thrombosis. Paroxysmal AF was associated with MI. These findings may have important clinical implications in AF patients.
Source: Clinical Research in Cardiology - October 24, 2020 Category: Cardiology Source Type: research

Edoxaban in atrial fibrillation patients with percutaneous coronary intervention by acute or chronic coronary syndrome presentation: a pre-specified analysis of the ENTRUST-AF PCI trial
Conclusions  In patients with AF who underwent PCI, the edoxaban-based regimen, as compared with VKA-based regimen, provides consistent safety and similar efficacy for ischaemic events in patients with AF regardless of their clinical presentation.
Source: European Heart Journal - August 29, 2020 Category: Cardiology 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

Dual Versus Triple Therapy for Atrial Fibrillation After Percutaneous Coronary Intervention: A Systematic Review and Meta-analysis.
Conclusion: In adults with AF after PCI, dual therapy reduces risk for bleeding compared with triple therapy, whereas its effects on risks for death and ischemic end points are still unclear. Primary Funding Source: None. PMID: 32176890 [PubMed - as supplied by publisher]
Source: Annals of Internal Medicine - March 16, 2020 Category: Internal Medicine Authors: Khan SU, Osman M, Khan MU, Khan MS, Zhao D, Mamas MA, Savji N, Al-Abdouh A, Hasan RK, Michos ED Tags: Ann Intern Med Source Type: research

Non-vitamin K antagonist oral anticoagulants (NOACs) post-percutaneous coronary intervention: a network meta-analysis.
CONCLUSIONS: Very low- to moderate-certainty evidence suggests no meaningful difference in efficacy outcomes between non-vitamin K antagonist oral anticoagulants (NOAC) and vitamin K antagonists following percutaneous coronary interventions (PCI) in people with non-valvular atrial fibrillation. NOACs probably reduce the risk of recurrent hospitalisation for adverse events compared with vitamin K antagonists. Low- to moderate-certainty evidence suggests that dabigatran may reduce the rates of major and non-major bleeding, and apixaban and rivaroxaban probably reduce the rates of non-major bleeding compared with vitamin K an...
Source: Cochrane Database of Systematic Reviews - December 18, 2019 Category: General Medicine Authors: Al Said S, Alabed S, Kaier K, Tan AR, Bode C, Meerpohl JJ, Duerschmied D Tags: Cochrane Database Syst Rev 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

Safety and Efficacy of Triple Antithrombotic Therapy with Dabigatran versus Vitamin K Antagonist in Atrial Fibrillation Patients: A Pilot Study.
Conclusion: Dabigatran at the dose used for stroke prevention appears safer than VKA and maintains a similar efficacy profile, when used with DAPT, in AF patients who have undergone PCI with stenting for ACS. PMID: 30895193 [PubMed - in process]
Source: Biomed Res - March 22, 2019 Category: Research Authors: Russo V, Rago A, Proietti R, Attena E, Rainone C, Crisci M, Papa AA, Calabrò P, D'Onofrio A, Golino P, Nigro G Tags: Biomed Res Int 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

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

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
ConclusionsA 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 10, 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

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

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