Title:Triple Antithrombotic Therapy vs. Double Antithrombotic Therapy: One Scenario, 8 Questions, Many Conclusions
Volume: 15
Issue: 3
Author(s): Elio Aloia*, Paolo Orselli and Carlotta Sciaccaluga
Affiliation:
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena,Italy
Keywords:
Triple antithrombotic therapy, dual antithrombotic therapy, atrial fibrillation, Percutaneous Coronary Intervention
(PCI), NOAC, OAC.
Abstract: In patients with atrial fibrillation undergoing percutaneous coronary intervention with the
placement of stents, a triple antithrombotic therapy is empirically established, which consists of a
combination of dual antithrombotic therapy (aspirin plus a P2Y12 inhibitor) and an oral anticoagulant
agent. This choice is guided by the desirable result of reducing cerebrovascular and coronary
ischemic events. However, there is an unwelcome outcome: an increased incidence of bleeding. On
this matter, in 2018, a North American Perspective Update was published, about a year later it was
followed by the publication of the European focus update on the dual antiplatelet therapy. After
analysing the main differences between these two consensus documents, this review aims at examining
the major studies on which they are based on, as a starting point to define the foundation of
new trials that can help shed light on this prominent topic.
