Download PDF
Thromb Haemost 2010; 103(01): 13-28
DOI: 10.1160/TH09-08-0580
Consensus Document
Schattauer GmbH

Management of Antithrombotic Therapy in Atrial Fibrillation Patients Presenting with Acute Coronary Syndrome and/or Undergoing Percutaneous Coronary Intervention/ Stenting

A Consensus Document of the European Society of Cardiology Working Group on Thrombosis, endorsed by the European Heart Rhythm Association [EHRA] and the European Association of Percutaneous Cardiovascular Interventions [EAPCI]
Gregory Y. H. Lip   *
1   University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, UK
,
Kurt Huber   **
2   3rd Department of Medicine, Cardiology and Emergency Medicine, Wilhelminen-hospital, Vienna, Austria
,
Felicita Andreotti   ***
3   Department of Cardiovascular Medicine, “A. Gemelli” University Hospital, Rome, Italy
,
Harald Arnesen   ***
4   Department of Cardiology, Oslo University Hospital, Ullevål, Oslo, Norway
,
K. Juhani Airaksinen   ***
5   Department of Medicine, Turku University Hospital, Turku, Finland
,
Thomas Cuisset   ***
6   Department of Cardiology, CHU Timone, Marseille, France
,
Paulus Kirchhof   ***
7   Department of Cardiology and Angiology, Universitätsklinikum Münster, Münster, Germany
,
Francisco Marín   ***
8   Department of Cardiology, Hospital Universitario Virgen de la Arrixaca, Ctra Madrid-Cartagena s/n, Murcia, Spain
› Author Affiliations
Further Information

Publication History

Received: 20 August 2009

Accepted: 12 September 2009

Publication Date:
22 November 2017 (online)

Also available at
    Permissions and Reprints

Summary

There remains uncertainty over optimal antithrombotic management strategy for patients with atrial fibrillation (AF) presenting with an acute coronary syndrome and/or undergoing percutaneous coronary intervention/stenting. Clinicians need to balance the risk of stroke and thromboembolism against the risk of recurrent cardiac ischaemia and/ or stent thrombosis, and the risk of bleeding. This consensus document comprehensively reviews the published evidence and presents a consensus statement on a ‘best practice’ antithrombotic therapy guideline for the management of antithrombotic therapy in such AF patients.

Keywords

Arial fibrillation - antithrombotic therapy - acute coronary syndrome - percutaneous coronary intervention - stenting - warfarin

* Chair of the Task Force


** Co-Chair of the Task Force


*** Member of the Task Force


 

  • References

  • 1 Lip GY, Lim HS. Atrial fibrillation and stroke prevention. Lancet Neurol 2007; 06: 981-993.
    CrossrefPubMedGoogle Scholar
  • 2 Nabauer M, Gerth A, Limbourg T. et al. The Registry of the German Competence NETwork on Atrial Fibrillation: patient characteristics and initial management. Europace 2009; 11: 423-434.
    PubMedGoogle Scholar
  • 3 Nieuwlaat R, Capucci A, Camm AJ. et al. European Heart Survey Investigators. Atrial fibrillation management: a prospective survey in ESC member countries: the Euro Heart Survey on Atrial Fibrillation. Eur Heart J 2005; 26: 2422-2434.
    CrossrefPubMedGoogle Scholar
  • 4 Stewart S, Hart CL, Hole DJ. et al. Population prevalence, incidence, and predictors of atrial fibrillation in the Renfrew/Paisley study. Heart 2001; 86: 516-521.
    CrossrefPubMedGoogle Scholar
  • 5 Kirchhof P, Auricchio A, Bax J. et al. Outcome parameters for trials in atrial fibrillation: recommendations from a consensus conference organized by the German Atrial Fibrillation Competence NETwork and the European Heart Rhythm Association. Europace 2007; 09: 1006-1023.
    CrossrefPubMedGoogle Scholar
  • 6 Connolly S, Pogue J, Hart R. et al. Clopidogrel plus aspirin versus oral anticoagulation for atrial fibrillation in the Atrial fibrillation Clopidogrel Trial with Irbesartan for prevention of Vascular Events (ACTIVE W): a randomised controlled trial. Lancet 2006; 367: 1903-1912.
    CrossrefPubMedGoogle Scholar
  • 7 Rubboli A, Milandri M, Castelvetri C. et al. Meta-analysis of trials comparing oral anticoagulation and aspirin versus dual antiplatelet therapy after coronary stenting. Clues for the management of patients with an indication for long-term anticoagulation undergoing coronary stenting. Cardiology 2005; 104: 101-106.
    CrossrefPubMedGoogle Scholar
  • 8 Bassand J, Hamm C, Ardissino D. et al. Guidelines for the diagnosis and treatment of non-ST-segment elevation acute coronary syndromes. Eur Heart J 2007; 28: 1598-1660.
    CrossrefPubMedGoogle Scholar
  • 9 Van de Werf F, Bax J, Betriu A. et al. Management of acute myocardial infarction in patients presenting with persistent ST-segment elevation: the Task Force on the Management of ST-Segment Elevation Acute Myocardial Infarction of the European Society of Cardiology. Eur Heart J 2008; 29: 2909-2945.
    CrossrefPubMedGoogle Scholar
  • 10 Fuster V, Ryden LE, Cannom DS. et al. Task Force on Practice Guidelines, American College of Cardiology/American Heart Association; Committee for Practice Guidelines, European Society of Cardiology; European Heart Rhythm Association; Heart Rhythm Society. ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation-executive summary: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients with Atrial Fibrillation). Eur Heart J 2006; 27: 1979-2030.
    CrossrefPubMedGoogle Scholar
  • 11 National Collaborating Centre for Chronic Conditions.. Atrial Fibrillation: national clinical guideline for management in primary and secondary care. London: Royal College of Physician; 2006
    Google Scholar
  • 12 Silber S, Albertsson P, Avile’s FF. et al. Task Force for Percutaneous Coronary Interventions of the European Society of Cardiology. Guidelines for percutaneous coronary interventions. The Task Force for Percutaneous Coronary Interventions of the European Society of Cardiology. Eur Heart J 2005; 26: 804-6473.395.
    CrossrefPubMedGoogle Scholar
  • 13 Anderson JL, Adams CD, Antman EM. et al.; American College of Cardiology; American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction); American College of Emergency Physicians; Society for Cardiovascular Angiography and Interventions; Society of Thoracic Surgeons; American Association of Cardiovascular and Pulmonary Rehabilitation; Society for Academic Emergency Medicine. ACC/AHA 2007 guidelines for the management of patients with unstable angina/nonST-Elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction) developed in collaboration with the American College of Emergency Physicians, the Society for Cardiovascular Angiography and Interventions, and the Society of Thoracic Surgeons endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation and the Society for Academic Emergency Medicine. J Am Coll Cardiol 2007; 50: e1-e157.
    CrossrefPubMedGoogle Scholar
  • 14 Becker RC, Meade TW, Berger PB. et al.; American College of Chest Physicians. The primary and secondary prevention of coronary artery disease: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Ed.). Chest 2008; 133 (Suppl. 06) 776S-814S.
    CrossrefPubMedGoogle Scholar
  • 15 Bejot Y, Ben Salem D, Osseby GV. et al. Epidemiology of ischemic stroke from atrial fibrillation in Dijon, France, from 1985 to 2006. Neurology 2009; 72: 346-353.
    CrossrefPubMedGoogle Scholar
  • 16 Gage BF, Waterman AD, Shannon W. et al. Validation of clinical classification schemes for predicting stroke: results from the National Registry of Atrial Fibrillation. J Am Med Assoc 2001; 285: 2864-2870.
    CrossrefPubMedGoogle Scholar
  • 17 Stroke Risk in Atrial Fibrillation Working Group.. Independent predictors of stroke in patients with atrial fibrillation: a systematic review. Neurology 2007; 69: 546-554.
    CrossrefPubMedGoogle Scholar
  • 18 Stroke Risk in Atrial Fibrillation Working Group.. Comparison of 12 Risk Stratification Schemes to Predict Stroke in Patients with Nonvalvular Atrial Fibrillation. Stroke 2008; 39: 1901-1910.
    CrossrefPubMedGoogle Scholar
  • 19 Hughes M, Lip GY. Guideline Development Group, National Clinical Guideline for Management of Atrial Fibrillation in Primary and Secondary Care, National Institute for Health and Clinical Excellence. Stroke and thromboembolism in atrial fibrillation: a systematic review of stroke risk factors, risk stratification schema and cost effectiveness data. Thromb Haemost 2008; 99: 295-304.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 20 Tay KH, Lane DA, Lip GY. Bleeding risks with combination of oral anticoagulation plus antiplatelet therapy: is clopidogrel any safer than aspirin when combined with warfarin?. Thromb Haemost 2008; 100: 955-957.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 21 Dahri K, Loewen P. The risk of bleeding with warfarin: a systematic review and performance analysis of clinical prediction rules. Thromb Haemost 2007; 98: 980-987.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 22 Hylek EM, Evans-Molina C, Shea C. et al. Major hemorrhage and tolerability of warfarin in the first year of therapy among elderly patients with atrial fibrillation. Circulation 2007; 115: 2689-2696.
    CrossrefPubMedGoogle Scholar
  • 23 Watson T, Shantsila E, Lip GYH. Mechanisms of thrombogenesis in atrial fibrillation: Virchow’s triad revisited. Lancet 2009; 373: 155-166.
    CrossrefPubMedGoogle Scholar
  • 24 Wysokinski WE, Owen WG, Fass DN. et al. Atrial fibrillation and thrombosis: immunohistochemical differences between insitu and embolized thrombi. J Thromb Haemost 2004; 02: 1637-1644.
    CrossrefPubMedGoogle Scholar
  • 25 Manning WJ, Silverman DI, Waksmonski CA. et al. Prevalence of residual left atrial thrombi among patients with acute thromboembolism and newly recognized atrial fibrillation. Arch Intern Med 1995; 15: 2193-2198.
    PubMedGoogle Scholar
  • 26 Goldsmith I, Kumar P, Carter P. et al. Atrial endocardial changes in mitral valve disease: a scanning electron microscopy study. Am Heart J 2000; 140: 777-784.
    CrossrefPubMedGoogle Scholar
  • 27 Nakamura Y, Nakamura K, Fukushima-Kusano K. et al. Tissue factor expression in atrial endothelia associated with nonvalvular atrial fibrillation: possible involvement in intracardiac thrombogenesis. Thromb Res 2003; 111: 137-142.
    CrossrefPubMedGoogle Scholar
  • 28 Kumagai K, Fukuchi M, Ohta J. et al. Expression of the von Willebrand Factor in atrial endocardium is increased in atrial fibrillation depending on th extent of structural remodeling. Circ J 2004; 68: 321-327.
    CrossrefPubMedGoogle Scholar
  • 29 Choudhury A, Lip GY. Atrial fibrillation and the hypercoagulable state: from basic science to clinical practice. Pathophysiol Haemost Thromb 2003; 33: 282-289.
    CrossrefPubMedGoogle Scholar
  • 30 Marin F, Roldan V, Lip GY. Fibrinolytic function and atrial fibrillation. Thromb Res 2003; 109: 233-240.
    CrossrefPubMedGoogle Scholar
  • 31 Yano Y, Ohmori T, Hoshide S. et al. Determinants of thrombin generation, fibrinolytic activity, and endothelial dysfunction in patients on dual antiplatelet therapy: involvement of factors other than platelet aggregability in Virchow’s triad. Eur Heart J 2008; 29: 1729-1738.
    CrossrefPubMedGoogle Scholar
  • 32 Lip GY. Does atrial fibrillation confer a hypercoagulable state?. Lancet 1995; 346: 1313-1314.
    CrossrefPubMedGoogle Scholar
  • 33 Lip GY, Patel JV, Hughes E. et al. High-sensitivity C-reactive protein and soluble CD40 ligand as indices of inflammation and platelet activation in 880 patients with nonvalvular atrial fibrillation: relationship to stroke risk factors, stroke risk stratification schema, and prognosis. Stroke 2007; 38: 1229-1237.
    CrossrefPubMedGoogle Scholar
  • 34 Conway DS, Pearce LA, Chin BS. et al. Prognostic value of plasma von Willebrand factor and soluble P-selectin as indices of endothelial damage and platelet activation in 994 patients with nonvalvular atrial fibrillation. Circulation 2003; 107: 3141-3145.
    CrossrefPubMedGoogle Scholar
  • 35 Vene N, Mavri A, Kosmelj K. et al. High D-dimer levels predict cardiovascular events in patients with chronic atrial fibrillation during anticoagulant therapy. Thromb Haemost 2003; 90: 1163-1172.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 36 Hart RG, Pearce LA, Aguilar MI. Meta-analysis: Antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation. Ann Intern Med 2007; 146: 857-867.
    CrossrefPubMedGoogle Scholar
  • 37 Connolly SJ, Pogue J, Hart RG. et al. Effect of clopidogrel added to aspirin in patients with atrial fibrillation. ACTIVE Investigators, N Engl J Med 2009; 360: 2066-2078.
    PubMedGoogle Scholar
  • 38 Lee KW, Lip GY. Acute coronary syndromes: Virchow’s triad revisited. Blood Coagul Fibrinolysis 2003; 14: 605-625.
    CrossrefPubMedGoogle Scholar
  • 39 Nakazawa G, Ladich E, Finn AV. et al. Pathophysiology of vascular healing and stent mediated arterial injury. EuroIntervention 2008; 04 Suppl C C7-10.
    PubMedGoogle Scholar
  • 40 Joner M, Finn AV, Farb A. et al. Pathology of drug-eluting stents in humans: delayed healing and late thrombotic risk. J Am Coll Cardiol 2006; 48: 193-202.
    CrossrefPubMedGoogle Scholar
  • 41 Nakazawa G, Finn AV, Joner M. et al. Delayed arterial healing and increased late stent thrombosis at culprit sites after drug-eluting stent placement for acute myocardial infarction patients: an autopsy study. Circulation 2008; 118: 1138-1145.
    CrossrefPubMedGoogle Scholar
  • 42 The Clopidogrel in Unstable Angina to Prevent Recurrent Events Trial Investigators.. Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation. N Engl J Med 2001; 345: 494-502.
    CrossrefPubMedGoogle Scholar
  • 43 Thrombosis prevention trial: randomised trial of low-intensity oral anticoagulation with warfarin and low-dose aspirin in the primary prevention of ischaemic heart disease in men at increased risk.. The Medical Research Council’s General Practice Research Framework. Lancet 1998; 351: 233-241.
    CrossrefPubMedGoogle Scholar
  • 44 Andreotti F, Testa L, Biondi-Zoccai GG. et al. Aspirin plus warfarin compared to aspirin alone after acute coronary syndromes: an updated and comprehensive meta-analysis of 25,307 patients. Eur Heart J 2006; 27: 519-526.
    CrossrefPubMedGoogle Scholar
  • 45 Testa L, Zoccai GB, Porto I. et al. Adjusted indirect meta-analysis of aspirin plus warfarin at international normalized ratios 2 to 3 versus aspirin plus clopidogrel after acute coronary syndromes. Am J Cardiol. 2007; 99: 1637-1642.
    CrossrefPubMedGoogle Scholar
  • 46 Ye Z, Liu EH, Higgins JP. et al. Seven haemostatic gene polymorphisms in coronary disease: meta-analysis of 66,155 cases and 91,307 controls. Lancet 2006; 367: 651-658.
    CrossrefPubMedGoogle Scholar
  • 47 Vlaar PJ, Svilaas T, van der Horst IC. et al. Cardiac death and reinfarction after 1 year in the Thrombus Aspiration during Percutaneous coronary intervention in Acute myocardial infarction Study (TAPAS): a 1-year follow-up study. Lancet 2008; 371: 1915-1920.
    CrossrefPubMedGoogle Scholar
  • 48 Graham I, Atar D, Borch-Johnsen K. et al.; European Society of Cardiology (ESC); European Association for Cardiovascular Prevention and Rehabilitation (EACPR); Council on Cardiovascular Nursing; European Association for Study of Diabetes (EASD); International Diabetes Federation Europe (IDF-Europe); European Stroke Initiative (EUSI); Society of Behavioural Medicine (ISBM); European Society of Hypertension (ESH); WONCA Europe (European Society of General Practice/Family Medicine); European Heart Network (EHN); European Atherosclerosis Society (EAS). European guidelines on cardiovascular disease prevention in clinical practice: full text. Fourth Joint Task Force of the European Society of Cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of nine societies and by invited experts). Eur J Cardiovasc Prev Rehabil 2007; 14 (Suppl. 02) S1-113.
    PubMedGoogle Scholar
  • 49 van Werkum JW, Heestermans AA, Zomer AC. et al. Predictors of coronary stent thrombosis: the Dutch Stent Thrombosis Registry. J Am Coll Cardiol 2009; 53: 1399-1409.
    CrossrefPubMedGoogle Scholar
  • 50 Cutlip D, Windecker S, Mehran R. et al. Clinical end points in coronary stent trials: a case for standardized definitions. Circulation 2007; 115: 2344-2351.
    CrossrefPubMedGoogle Scholar
  • 51 Spaulding C, Daemen J, Boersma E. et al. A pooled analysis of data comparing sirolimus-eluting stents with bare-metal stents. N Engl J Med 2007; 356: 989-997.
    CrossrefPubMedGoogle Scholar
  • 52 Stone GW, Moses JW, Ellis SG. et al. Safety and efficacy of sirolimus- and paclitaxel-eluting coronary stents. N Engl J Med 2007; 356: 998-1008.
    CrossrefPubMedGoogle Scholar
  • 53 Aoki J, Lansky AJ, Mehran R. et al. Early stent thrombosis in patients with acute coronary syndromes treated with drug-eluting and bare metal stents: the Acute Catheterization and Urgent Intervention Triage Strategy trial. Circulation 2009; 119: 657-659.
    CrossrefPubMedGoogle Scholar
  • 54 Sibbing D, Stegherr J, Latz W. et al. Cytochrome P450 2C19 loss-of-function polymorphism and stent thrombosis following percutaneous coronary intervention. Eur Heart J 2009; 30: 916-922.
    PubMedGoogle Scholar
  • 55 Rossini R, Musumeci G, Lettieri C. et al. Long-term outcomes in patients undergoing coronary stenting on dual oral antiplatelet treatment requiring oral anticoagulant therapy. Am J Cardiol 2008; 102: 1618-1623.
    CrossrefPubMedGoogle Scholar
  • 56 Rubboli A, Colletta M, Valencia J. et al.; for the WARfarin and Coronary STENTing (WAR-STENT) Study Group. Periprocedural Management and In-Hospital Outcome of Patients with Indication for Oral Anticoagulation Undergoing Coronary Artery Stenting. J Interv Cardiol 2009; 22: 390-397.
    CrossrefPubMedGoogle Scholar
  • 57 Rubboli A, Halperin J, Airaksinen K. et al. Antithrombotic therapy in patients treated with oral anticoagulation undergoing coronary artery stenting. An expert consensus document with focus on atrial fibrillation. Ann Med 2008; 40: 428-436.
    CrossrefPubMedGoogle Scholar
  • 58 Wang T, Robinson L, Ou F. et al. Discharge antithrombotic strategies among patients with acute coronary syndrome previously on warfarin anticoagulation: physician practice in the CRUSADE registry. Am Heart J 2008; 155: 361-368.
    CrossrefPubMedGoogle Scholar
  • 59 Ruiz-Nodar J, Marín F, Hurtado J. et al. Anticoagulant and antiplatelet therapy use in 426 patients with atrial fibrillation undergoing percutaneous coronary intervention and stent implantation implications for bleeding risk and prognosis. J Am Coll Cardiol 2008; 51: 818-825.
    CrossrefPubMedGoogle Scholar
  • 60 Karjalainen P, Porela P, Ylitalo A. et al. Safety and efficacy of combined antiplatelet-warfarin therapy after coronary stenting. Eur Heart J 2007; 28: 726-732.
    CrossrefPubMedGoogle Scholar
  • 61 Stenestrand U, Lindbäck J, Wallentin L. RIKS-HIA Registry. Anticoagulation therapy in atrial fibrillation in combination with acute myocardial infarction influences long-term outcome: a prospective cohort study from the Register of Information and Knowledge About Swedish Heart Intensive Care Admissions (RIKS-HIA). Circulation 2005; 112: 3225-3231.
    CrossrefPubMedGoogle Scholar
  • 62 Larson B, Zumberg M, Kitchens C. A feasibility study of continuing dose-reduced warfarin for invasive procedures in patients with high thromboembolic risk. Chest 2005; 127: 922-927.
    CrossrefPubMedGoogle Scholar
  • 63 Spyropoulos A, Turpie A. Perioperative bridging interruption with heparin for the patient receiving long-term anticoagulation. Curr Opin Pulm Med 2005; 11: 373-379.
    PubMedGoogle Scholar
  • 64 Spyropoulos A, Turpie A, Dunn A. et al. Clinical outcomes with unfractionated heparin or low-molecular-weight heparin as bridging therapy in patients on long-term oral anticoagulants: the REGIMEN registry. J Thromb Haemost 2006; 04: 1246-1252.
    CrossrefPubMedGoogle Scholar
  • 65 Kovacs M, Kearon C, Rodger M. et al. Single-arm study of bridging therapy with low-molecular-weight heparin for patients at risk of arterial embolism who require temporary interruption of warfarin. Circulation 2004; 110: 1658-1663.
    CrossrefPubMedGoogle Scholar
  • 66 Jaffer A, Ahmed M, Brotman D. et al. Low-molecular-weight-heparins as periprocedural anticoagulation for patients on long-term warfarin therapy: a standardized bridging therapy protocol. J Thromb Thrombolysis 2005; 20: 11-16.
    CrossrefPubMedGoogle Scholar
  • 67 Douketis J, Johnson J, Turpie A. Low-molecular-weight heparin as bridging anticoagulation during interruption of warfarin: assessment of a standardized peri-procedural anticoagulation regimen. Arch Intern Med 2004; 164: 1319-1326.
    CrossrefPubMedGoogle Scholar
  • 68 MacDonald L, Meyers S, Bennett C. et al. Post-cardiac catheterization access site complications and low-molecular -weight heparin following cardiac catheterization. J Invasive Cardiol 2003; 15: 60-62.
    PubMedGoogle Scholar
  • 69 Stabile E, Nammas W, Salemme L. et al. The CIAO (Coronary Interventions Anti-platelet-based Only) Study: a randomized study comparing standard anticoagulation regimen to absence of anticoagulation for elective percutaneous coronary intervention. J Am Coll Cardiol 2008; 52: 1293-1298.
    CrossrefPubMedGoogle Scholar
  • 70 Chang R, Doherty T, Goldberg S. How does warfarin affect the activated coagulation time?. Am Heart J 1998; 136: 477-479.
    CrossrefPubMedGoogle Scholar
  • 71 Annala A, Karjalainen P, Porela P. et al. Safety of diagnostic coronary angiography during uninterrupted therapeutic warfarin treatment. Am J Cardiol 2008; 102: 386-390.
    CrossrefPubMedGoogle Scholar
  • 72 Karjalainen P, Vikman S, Niemelä M. et al. Safety of percutaneous coronary intervention during uninterrupted oral anticoagulant treatment. Eur Heart J 2008; 29: 1001-1010.
    CrossrefPubMedGoogle Scholar
  • 73 Wazni O, Beheiry S, Fahmy T. et al. Atrial fibrillation ablation in patients with therapeutic international normalized ratio: comparison of strategies of anticoagulation management in the periprocedural period. Circulation 2007; 116: 2531-2534.
    CrossrefPubMedGoogle Scholar
  • 74 Jessup D, Coletti A, Muhlestein J. et al. Elective coronary angiography and percutaneous coronary intervention during uninterrupted warfarin therapy. Catheter Cardiovasc Interv 2003; 60: 180-184.
    CrossrefPubMedGoogle Scholar
  • 75 Helft G, Dambrin G, Zaman A. et al. Percutaneous coronary intervention in anticoagulated patients via radial artery access. Catheter Cardiovasc Interv 2009; 73: 44-47.
    CrossrefPubMedGoogle Scholar
  • 76 ten Berg J, Hutten B, Kelder J. et al. Oral anticoagulant therapy during and after coronary angioplasty the intensity and duration of anticoagulation are essential to reduce thrombotic complications. Circulation 2001; 103: 2042-2047.
    CrossrefPubMedGoogle Scholar
  • 77 El-Jack S, Ruygrok P, Webster M. et al. Effectiveness of manual pressure hemostasis following transfemoral coronary angiography in patients on therapeutic warfarin anticoagulation. Am J Cardiol 2006; 97: 485-488.
    CrossrefPubMedGoogle Scholar
  • 78 Palareti G, Legnani C, Poller L. et al. Warfarin withdrawal. Pharmacokinetic-pharmacodynamic considerations and evidence for “rebound” hypercoagulability after stopping anticoagulants. Clin Pharmacokinet 1996; 30: 300-313.
    CrossrefPubMedGoogle Scholar
  • 79 White H, Kleiman N, Mahaffey K. et al. Efficacy and safety of enoxaparin compared with unfractionated heparin in high-risk patients with non-ST-segment elevation acute coronary syndrome undergoing percutaneous coronary intervention in the Superior Yield of the New Strategy of Enoxaparin, Revascularization and Glycoprotein IIb/IIIa Inhibitors (SYNERGY) trial. Am Heart J 2006; 152: 1042-1050.
    CrossrefPubMedGoogle Scholar
  • 80 Szük T, Gyöngyösi M, Homorodi N. et al. Effect of timing of clopidogrel administration on 30-day clinical outcomes: 300-mg loading dose immediately after coronary stenting versus pretreatment 6 to 24 hours before stenting in a large unselected patient cohort. Am Heart J 2007; 153: 289-295.
    CrossrefPubMedGoogle Scholar
  • 81 Boersma E, Harrington R, Moliterno D. et al. Platelet glycoprotein IIb/IIIa inhibitors in acute coronary syndromes: a meta-analysis of all major randomised clinical trials. Lancet 2002; 359: 189-198.
    CrossrefPubMedGoogle Scholar
  • 82 Alexander K, Chen A, Newby L. et al. Sex differences in major bleeding with glycoprotein IIb/IIIa inhibitors: results from the CRUSADE (Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA guidelines) initiative. Circulation 2006; 114: 1380-1387.
    CrossrefPubMedGoogle Scholar
  • 83 Manzano-Fernández S, Pastor F, Marín F. et al. Increased major bleeding complications related to triple antithrombotic therapy usage in patients with atrial fibrillation undergoing percutaneous coronary artery stenting. Chest 2008; 134: 559-567.
    CrossrefPubMedGoogle Scholar
  • 84 Lopes R, Pieper K, Horton J. et al. Short- and long-term outcomes following atrial fibrillation in patients with acute coronary syndromes with or without ST-segment elevation. Heart 2008; 94: 867-873.
    CrossrefPubMedGoogle Scholar
  • 85 Kastrati A, Mehilli J, Schühlen H. et al.; Intracoronary Stenting and Antithrombotic Regimen-Rapid Early Action for Coronary Treatment Study Investigators. A clinical trial of abciximab in elective percutaneous coronary intervention after pretreatment with clopidogrel. N Engl J Med 2004; 350: 232-238.
    CrossrefPubMedGoogle Scholar
  • 86 Kastrati A, Mehilli J, Neumann FJ. et al.; Intracoronary Stenting and Antithrombotic: Regimen Rapid Early Action for Coronary Treatment 2 (ISAR-REACT 2) Trial Investigators. Abciximab in patients with acute coronary syndromes undergoing percutaneous coronary intervention after clopidogrel pretreatment: the ISAR-REACT 2 randomized trial. J Am Med Assoc 2006; 295: 1531-1538.
    CrossrefPubMedGoogle Scholar
  • 87 Stone GW, Witzenbichler B, Guagliumi G. et al.; HORIZONS-AMI Trial Investigators. Bivalirudin during primary PCI in acute myocardial infarction. N Engl J Med 2008; 358: 2218-2230.
    CrossrefPubMedGoogle Scholar
  • 88 Stone GW, White HD, Ohman EM. et al.; Acute Catheterization and Urgent Intervention Triage strategy (ACUITY) trial investigators. Bivalirudin in patients with acute coronary syndromes undergoing percutaneous coronary intervention: a subgroup analysis from the Acute Catheterization and Urgent Intervention Triage strategy (ACUITY) trial. Lancet 2007; 369: 907-919.
    CrossrefPubMedGoogle Scholar
  • 89 Agostoni P, Biondi-Zoccai G, de Benedictis M. et al. Radial versus femoral approach for percutaneous coronary diagnostic and interventional procedures; Systematic overview and meta-analysis of randomized trials. J Am Coll Cardiol 2004; 44: 349-356.
    CrossrefPubMedGoogle Scholar
  • 90 Chase A, Fretz E, Warburton W. et al. Association of the arterial access site at angioplasty with transfusion and mortality: the M.O.R.T.A.L study (Mortality benefit Of Reduced Transfusion after percutaneous coronary intervention via the Arm or Leg). Heart 2008; 94: 1019-1025.
    CrossrefPubMedGoogle Scholar
  • 91 Jolly SS, Amlani S, Hamon M. et al. Radial versus femoral access for coronary angiography or intervention and the impact on major bleeding and ischemic events: a systematic review and meta-analysis of randomized trials. Am Heart J 2009; 157: 132-140.
    CrossrefPubMedGoogle Scholar
  • 92 Koreny M, Riedmüller E, Nikfardjam M. et al. Arterial puncture closing devices compared with standard manual compression after cardiac catheterization: systematic review and meta-analysis. J Am Med Assoc 2004; 291: 350-357.
    CrossrefPubMedGoogle Scholar
  • 93 Bertrand M, Legrand V, Boland J. et al. Randomized multicenter comparison of conventional anticoagulation versus antiplatelet therapy in unplanned and elective coronary stenting. The full anticoagulation versus aspirin and ticlopidine (fantastic) study. Circulation 1998; 98: 1597-1603.
    CrossrefPubMedGoogle Scholar
  • 94 Urban P, Macaya C, Rupprecht H. et al. Randomized evaluation of anticoagulation versus antiplatelet therapy after coronary stent implantation in high-risk patients: the multicenter aspirin and ticlopidine trial after intracoronary stenting (MATTIS). Circulation 1998; 98: 2126-2132.
    CrossrefPubMedGoogle Scholar
  • 95 Leon MB, Baim DS, Popma JJ. et al. A clinical trial comparing three antithrombotic-drug regimens after coronary-artery stenting. Stent Anticoagulation Restenosis Study Investigators. N Engl J Med 1998; 339: 1665-1671.
    CrossrefPubMedGoogle Scholar
  • 96 Aoki J, Lansky AJ, Mehran R. et al. Early stent thrombosis in patients with acute coronary syndromes treated with drug-eluting and bare metal stents: the Acute Catheterization and Urgent Intervention Triage Strategy trial. Circulation 2009; 119: 687-698.
    CrossrefPubMedGoogle Scholar
  • 97 Cutlip D, Windecker S, Mehran R. et al. Clinical end points in coronary stent trials: a case for standardized definitions. Circulation 2007; 115: 2344-2351.
    CrossrefPubMedGoogle Scholar
  • 98 Rubboli A, Colletta M, Herzfeld J. et al. Periprocedural and medium-term anti-thrombotic strategies in patients with an indication for long-term anticoagulation undergoing coronary angiography and intervention. Coron Artery Dis 2007; 18: 193-199.
    CrossrefPubMedGoogle Scholar
  • 99 Nguyen M, Lim Y, Walton A. et al. Combining warfarin and antiplatelet therapy after coronary stenting in the Global Registry of Acute Coronary Events: is it safe and effective to use just one antiplatelet agent?. Eur Heart J 2007; 28: 1717-1722.
    CrossrefPubMedGoogle Scholar
  • 100 Ruiz-Nodar JM, Marin F, Sanchez-Paya J. et al. Efficay and safety of drug-eluting stent use in patients with atrial fibrillation. Eur Heart J 2009; 30: 932-939.
    PubMedGoogle Scholar
  • 101 Karjalainen P, Ylitalo A, Niemelä M. et al. Titanium-nitride-oxide coated stents versus paclitaxel-eluting stents in acute myocardial infarction: a 12-months follow-up report from the TITAX AMI trial. EuroIntervention 2008; 04: 234-241.
    CrossrefPubMedGoogle Scholar
  • 102 Bartorelli A, Tamburino C, Trabattoni D. et al. Comparison of two antiplatelet regimens (aspirin alone versus aspirin + ticlopidine or clopidogrel) after intra-coronary implantation of a carbofilm-coated stent. Am J Cardiol 2007; 99: 1062-1066.
    CrossrefPubMedGoogle Scholar
  • 103 Co M, Tay E, Lee C. et al. Use of endothelial progenitor cell capture stent (Genous Bio-Engineered R Stent) during primary percutaneous coronary intervention in acute myocardial infarction: intermediate- to long-term clinical follow-up. Am Heart J 2008; 155: 128-132.
    CrossrefPubMedGoogle Scholar
  • 104 Chevalier C, Silber S, Park SJ. et al.; for the NOBORI 1 Clinical Investigators. Randomized Comparison of the Nobori Biolimus A9-Eluting Coronary Stent With the Taxus Liberté Paclitaxel-Eluting Coronary Stent in Patients With Stenosis in Native Coronary Arteries. The NOBORI 1 Trial—Phase 2. Circulation: Cardiovascular Interventions 2009; 02: 188-195.
    CrossrefPubMedGoogle Scholar
  • 105 Mant J, Hobbs FD, Fletcher K. et al.; BAFTA Investigators; Midland Research Practices Network (MidReC). Warfarin versus aspirin for stroke prevention in an elderly community population with atrial fibrillation (the Birmingham Atrial Fibrillation Treatment of the Aged Study, BAFTA): a randomised controlled trial. Lancet 2007; 370: 493-503.
    CrossrefPubMedGoogle Scholar
  • 106 Moscucci M, Fox K, Cannon C. et al. Predictors of major bleeding in acute coronary syndromes: the Global Registry of Acute Coronary Events (GRACE). Eur Heart J 2003; 24: 1815-1823.
    CrossrefPubMedGoogle Scholar
  • 107 Subherwal S, Bach RG, Chen AY. et al. Baseline risk of major bleeding in non-ST-segment-elevation myocardial infarction: the CRUSADE (Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA Guidelines) Bleeding Score. Circulation 2009; 119: 1873-1882 1846-1849.
    CrossrefPubMedGoogle Scholar
  • 108 Nikolsky E, Mehran R, Dangas G. et al. Development and validation of a prognostic risk score for major bleeding in patients undergoing percutaneous coronary intervention via the femoral approach. Eur Heart J 2007; 28: 1936-1945.
    CrossrefPubMedGoogle Scholar
  • 109 Bertrand M, Collet J, Montalescot G. Non-ST-segment elevation acute coronary syndromes: an algorithm for decision. Eur Heart J 2008; 29: 279-280.
    PubMedGoogle Scholar
  • 110 Beyth R, Quinn L, Landefeld C. Prospective evaluation of an index for predicting the risk of major bleeding in outpatients treated with warfarin. Am J Med 1998; 105: 91-99.
    CrossrefPubMedGoogle Scholar
  • 111 Sarafoff N, Ndrepepa G, Mehilli J. et al. Aspirin and clopidogrel with or without phenprocoumon after drug eluting coronary stent placement in patients on chronic oral anticoagulation. J Intern Med 2008; 264: 472-480.
    CrossrefPubMedGoogle Scholar
  • 112 Rossini R, Musumeci G, Lettieri C. et al. Long-term outcomes in patients undergoing coronary stenting on dual oral antiplatelet treatment requiring oral anticoagulant therapy. Am J Cardiol 2008; 102: 1618-1623.
    CrossrefPubMedGoogle Scholar
  • 113 Bhatt DL, Scheiman J, Abraham NS. et al.; American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents. ACCF/ACG/ AHA 2008 expert consensus document on reducing the gastrointestinal risks of antiplatelet therapy and NSAID use: a report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents. J Am Coll Cardiol 2008; 52: 1502-1517.
    CrossrefPubMedGoogle Scholar
  • 114 Gilard M, Arnaud B, Le Gal G. et al. Influence of omeprazole on the antiplatelet action of clopidogrel associated to aspirin. J Thromb Haemost 2006; 04: 2508-2509.
    CrossrefPubMedGoogle Scholar
  • 115 Ho PM, Maddox TM, Wang L. et al. Risk of adverse outcomes associated with concomitant use of clopidogrel and proton pump inhibitors following acute coronary syndrome. J Am Med Assoc 2009; 301: 937-944.
    CrossrefPubMedGoogle Scholar
  • 116 Small DS, Farid NA, Payne CD. et al. Effects of the proton pump inhibitor lansoprazole on the pharmacokinetics and pharmacodynamics of prasugrel and clopidogrel. J Clin Pharmacol 2008; 48: 475-484.
    CrossrefPubMedGoogle Scholar
  • 117 Siller-Matula JM, Spiel AO, Lang IM. et al. Effects of pantoprazole and esomeprazole on platelet inhibition by clopidogrel. Am Heart J 2009; 157: 148e141-145.
    PubMedGoogle Scholar
  • 118 O’Donoghue ML, Braunwald E, Antman EM. et al. Pharmacodynamic effect and clinical efficacy of clopidogrel and prasugrel with or without a proton-pump inhibitor: an analysis of two randomised trials. Lancet. 2009 prepublished online.
    PubMedGoogle Scholar
  • 119 Bhatt DL. COGENT: A prospective, randomized, placebo-controlled trial of omeprazole in patients receiving aspirin and clopidogrel. Presented at the TCT Congress 2009 in San Francisco. Available at: www.tctmd.com/show.aspx?id=86168.
    PubMedGoogle Scholar
  • 120 Hughes M, Lip GYH. Guideline Development Group for the NICE national clinical guideline for management of atrial fibrillation in primary and secondary care. Risk factors for anticoagulation-related bleeding complications in patients with atrial fibrillation: a systemic review. QJM 2007; 100: 599-607.
    CrossrefPubMedGoogle Scholar
  • 121 Torosian M, Michelson EL, Morganroth J. et al. Aspirin- and coumadin-related bleeding after coronary- artery bypass graft surgery. Ann Intern Med 1978; 89: 325-328.
    CrossrefPubMedGoogle Scholar
  • 122 Kim JH-J, Newby K, Clare RM. et al. Clopidogrel use and bleeding after coronary artery bypass graft surgery. Am Heart J 2008; 156: 8886-892l.
    PubMedGoogle Scholar
  • 123 Khurram Z, Chou E, Minutello R. et al. Combination therapy with aspirin, clopidogrel and warfarin following coronary stenting is associated with a significant risk of bleeding. J Invasive Cardiol 2006; 18: 162-164.
    PubMedGoogle Scholar
  • 124 Orford JL, Fasseas P, Melby S. et al. Safety and efficacy of aspirin, clopidogrel, and warfarin after coronary stent placement in patients with an indication for anticoagulation. Am Heart J 2004; 147: 463-467.
    CrossrefPubMedGoogle Scholar
  • 125 Maegdefessel L, Schlitt A, Faerber J. et al. Anticoagulant and/or antiplatelet treatment in patients with atrial fibrillation after percutaneous coronary intervention. A single-center experience. Med Klin (Munich) 2008; 103: 628-632.
    CrossrefPubMedGoogle Scholar
  • 126 Lip GY, Karpha M. Anticoagulant and antiplatelet therapy use in patients with atrial fibrillation undergoing percutaneous coronary intervention: the need for consensus and a management guideline. Chest 2006; 130: 1823-1827.
    CrossrefPubMedGoogle Scholar
  • 127 Rossini R, Musumeci G, Lettieri C. et al. Long-term outcomes in patients undergoing coronary stenting on dual oral antiplatelet treatment requiring oral anticoagulant therapy. Am J Cardiol 2008; 102: 1618-1623.
    CrossrefPubMedGoogle Scholar
  • 128 Rogacka R, Chieffo A, Michev I. et al. Dual antiplatelet therapy after percutaneous coronary intervention with stent implantation in patients taking chronic oral antiocoagulation. J Am Coll Cardiol Interv 2008; 01: 56-61.
    CrossrefPubMedGoogle Scholar
  • 129 Porter A, Konstantino Y, Iakobishvili Z. et al. Short-term triple therapy with aspirin, warfarin, and a thienopyridine among patients undergoing percutaneous coronary intervention. Catheter Cardiovasc Interv 2006; 68: 56-61.
    CrossrefPubMedGoogle Scholar
  • 130 Manzano-Fernandez S, Marin F, Pastor-Perez FJ. et al. Impact of Chronic Kidney Disease on Major Bleeding Complications and Mortality in Patients With Indication for Oral Anticoagulation Undergoing Coronary Stenting. Chest 2009; 135: 983-990.
    CrossrefPubMedGoogle Scholar
  • 131 DeEugenio D, Kolman L, DeCaro M. et al. Risk of major bleeding with concomitant dual antiplatelet therapy after percutaneous coronary intervention in patients receiving long-term warfarin therapy. Pharmacotherapy 2007; 27: 691-696.
    CrossrefPubMedGoogle Scholar
  • 132 Nikolsky E, Mehran R, Halkin A. et al. Vascular complications associated with arteriotomy closure devices in patients undergoing percutaneous coronary procedures: a meta-analysis. J Am Coll Cardiol 2004; 44: 1200-1209.
    PubMedGoogle Scholar
  • 133 Schomig A, Neumann FJ, Kastrati A. et al. A randomized comparison of antiplatelet and anticoagulant therapy after the placement of coronary-artery stents. N Engl J Med 1996; 334: 1084-1089.
    CrossrefPubMedGoogle Scholar
  • 134 Urban P, Macaya C, Rupprecht HJ. et al. Randomized evaluation of anticoagulation versus antiplatelet therapy after coronary stent implantation in high-risk patients: the multicenter aspirin and ticlopidine trial after intracoronary stenting (MATTIS). Circulation 1998; 98: 2126-2132.
    CrossrefPubMedGoogle Scholar
  • 135 Bertrand ME, Legrand V, Boland J. et al. Randomized multicenter comparison of conventional anticoagulation versus antiplatelet therapy in unplanned and elective coronary stenting. The full anticoagulation versus aspirin and ticlopidine (fantastic) study. Circulation 1998; 98: 1597-1603.
    CrossrefPubMedGoogle Scholar
  • 136 Rubboli A, Halperin JL. Pro: ‘Antithrombotic therapy with warfarin, aspirin and clopidogrel is the recommended regime in anticoagulated patients who present with an acute coronary syndrome and/or undergo percutaneous coronary interventions‘. Thromb Haemost 2008; 100: 752-753.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 137 Roldán V, Marín F. Contra: ‘Antithrombotic therapy with warfarin, aspirin and clopidogrel is the recommended regimen in anticoagulated patients who present with an acute coronary syndrome and/or undergo percutaneous coronary interventions‘. Not for everybody. Thromb Haemost 2008; 100: 754-755.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 138 McBane RD, Hodge DO, Wysokinski WE. Clinical and echocardiographic measures governing thromboembolism destination in atrial fibrillation. Thromb Haemost 2008; 99: 951-955.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 139 Lip GY. Paroxysmal atrial fibrillation, stroke risk and thromboprophylaxis. Thromb Haemost 2008; 100: 11-13.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 140 Wiviott SD, Braunwald E, McCabe CH. et al.; TRITON-TIMI 38 Investigators. Prasugrel versus clopidogrel in patients with acute coronary syndromes. N Engl J Med 2007; 357: 2001-2015.
    CrossrefPubMedGoogle Scholar
  • 141 Management of Patients With Atrial Fibrillation Undergoing Coronary Artery Stenting (AFCAS). http://clinicaltrials.gov/ct2/show/NCT00596570 [accessed 6th June 2009].
    PubMedGoogle Scholar
  • 142 Triple Therapy in Patients on Oral Anticoagulation After Drug Eluting Stent Implantation (ISAR-TRIPLE). http://clinicaltrials.gov/ct2/show/NCT00776633 [accessed 6th June 2009].
    PubMedGoogle Scholar
  • 143 What is the Optimal antiplatElet and anticoagulant in patients with oral anticoagulation and StenTing (WOEST) study. http://www.clinicaltrials.gov/ct2/show/NCT00769938?term=WOEST&rank=1 [accessed 6th June 2009].
    PubMedGoogle Scholar
  • 144 Khoo CW, Tay KH, Shantsila E. et al. Novel oral anticoagulants. Int J Clin Pract 2009; 63: 630-641.
    CrossrefPubMedGoogle Scholar
  • 145 Rubboli A, Colletta M, Sangiorgio P. et al. Antithrombotic strategies in patients with an indication for long-term anticoagulation undergoing coronary artery stenting: safety and efficacy data from a single center. Ital Heart J 2004; 05: 919-925.
    PubMedGoogle Scholar
  • 146 Mattichak SJ, Reed PS, Gallagher MJ. et al. Evaluation of safety of warfarin in combination with antiplatelet therapy for patients treated with coronary stents for acute myocardial infarction. J Interv Cardiol 2005; 18: 163-166.
    CrossrefPubMedGoogle Scholar