Title:Antithrombotic Strategies in Patients with Atrial Fibrillation Undergoing Percutaneous Coronary Intervention
Volume: 24
Issue: 4
Author(s): Daorong Pan, Xiaomin Ren and Zuoying Hu*
Affiliation:
- Department of Cardiology, Nanjing Medical University Affiliated Nanjing Hospital, Nanjing Medical University, Nanjing,China
Keywords:
Antithrombotic therapy, coronary artery disease, atrial fibrillation, anticoagulants, antiplatelet therapy, percutaneous coronary
intervention.
Abstract: The optimal strategy of antithrombotic therapy for patients with atrial fibrillation (AF) undergoing
percutaneous coronary intervention remains to be a question to be answered. The major challenge in such population
is the balance between the benefit of reduced stroke and coronary ischemic events, against the risk of increased
bleeding complications. Thus, both thrombotic and bleeding risk assessments should be included into
clinical decision-making process for such patients. Currently, there is limited evidence based on randomized trials
with adequate power to show the superiority of any strategy in the beneficial profile of safety and efficacy, thus
limited recommendations are provided by clinical guidelines. Given the recent advancement in this field, our
review provided an overview of the available risk stratification schemes for stroke and bleeding risk for AF patients,
discussed the multiple questions in the optimal regimens of oral antiplatelet and anticoagulation therapy,
and summarized evidence and recommendations related to long-term antithrombotic therapy for AF patients
receiving stent implications.
