Management of Antithrombotic Therapy in Atrial Fibrillation Patients Undergoing PCI: JACC State-of-the-Art Review.


Journal

Journal of the American College of Cardiology
ISSN: 1558-3597
Titre abrégé: J Am Coll Cardiol
Pays: United States
ID NLM: 8301365

Informations de publication

Date de publication:
09 07 2019
Historique:
received: 24 04 2019
revised: 10 05 2019
accepted: 13 05 2019
entrez: 6 7 2019
pubmed: 6 7 2019
medline: 21 5 2020
Statut: ppublish

Résumé

Most patients with atrial fibrillation (AF) and risk factors for stroke require oral anticoagulation (OAC) to decrease the risk of stroke or systemic embolism. This is now best achieved with direct oral anticoagulants that decrease the risk of intracranial bleeding compared with vitamin K antagonists. Of note, approximately 5% to 10% of patients undergoing percutaneous coronary intervention have AF, which complicates antithrombotic therapy in daily practice, because the guidelines recommend that these patients also receive dual antiplatelet therapy (DAPT) to reduce the risk of ischemic complications. However, combining OAC with DAPT, a strategy also known as triple antithrombotic therapy, is known to increase the risk of bleeding compared with the use of OAC or DAPT alone. Studies of direct oral anticoagulants are now emerging that show the favorable safety profile of double antithrombotic therapy with OAC and a P2Y

Identifiants

pubmed: 31272556
pii: S0735-1097(19)35208-8
doi: 10.1016/j.jacc.2019.05.016
pii:
doi:

Substances chimiques

Fibrinolytic Agents 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

83-99

Informations de copyright

Copyright © 2019 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Auteurs

Davide Capodanno (D)

Division of Cardiology, A.O.U. "Policlinico-Vittorio Emanuele," University of Catania, Catania, Italy. Electronic address: https://twitter.com/DFCapodanno.

Kurt Huber (K)

3rd Medical Department, Cardiology and Intensive Care Medicine and Sigmund Freud University, Medical Faculty, Vienna, Austria.

Roxana Mehran (R)

Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York.

Gregory Y H Lip (GYH)

Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom; Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.

David P Faxon (DP)

Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston, Massachusetts.

Christopher B Granger (CB)

Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina.

Pascal Vranckx (P)

Department of Cardiology and Critical Care Medicine, Hartcentrum Hasselt, and faculty of Medicine and Life Sciences at the University of Hasselt, Hasselt, Belgium.

Renato D Lopes (RD)

Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina.

Gilles Montalescot (G)

Cardiology Department, Nîmes University Hospital, ACTION Study Group, Montpellier University, Nîmes, France.

Christopher P Cannon (CP)

Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston, Massachusetts.

Jurien Ten Berg (J)

Department of Cardiology, St. Antonius Hospital, Nieuwegein, the Netherlands.

Bernard J Gersh (BJ)

Mayo Clinic College of Medicine, Rochester, Minnesota.

Deepak L Bhatt (DL)

Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston, Massachusetts.

Dominick J Angiolillo (DJ)

Division of Cardiology, University of Florida College of Medicine, Jacksonville, Florida. Electronic address: dominick.angiolillo@jax.ufl.edu.

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Classifications MeSH