Consensus Document: Antithrombotic therapy in patients with atrial fibrillation undergoing coronary stenting

David P. Faxon; John W. Eikelboom; Peter B. Berger; David R. Holmes; Deepak L. Bhatt; David J. Moliterno; Richard C. Becker; Dominick J. Angiolill

doi:10.1160/TH11-04-0262

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2011; 106(04): 571-584
DOI: 10.1160/TH11-04-0262

Consensus Document

Schattauer GmbH

Consensus Document: Antithrombotic therapy in patients with atrial fibrillation undergoing coronary stenting^[*]

A North-American perspective

David P. Faxon

¹Division of Cardiology, Brigham and Women’s Hospital, Boston, Massachusetts, USA

,

John W. Eikelboom

²Department of Medicine, Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada

,

Peter B. Berger

³Geisinger Clinic, Danville, Pennsylvania, USA

,

David R. Holmes

⁴Mayo Clinic, Rochester, Minnesota, USA

,

Deepak L. Bhatt

⁵Division of Cardiology, VA Boston Health System, Boston, Massachusetts, USA

,

David J. Moliterno

⁶Gill Heart Institute and Division of Cardiovascular Medicine, University of Kentucky, Lexington, Kentucky, USA

,

Richard C. Becker

⁷Divisions of Cardiology and Hematology, Duke University School of Medicine, Durham, North Carolina, USA

,

Dominick J. Angiolill

⁸Division of Cardiology, University of Florida College of Medicine-Jacksonville, Jacksonville, Florida, USA

› Author Affiliations

Abstract

Summary

The optimal regimen of the anticoagulant and antiplatelet therapies in patients with atrial fibrillation who have had a coronary stent is unclear. It is well recognised that “triple therapy” with aspirin, clopidogrel, and warfarin is associated with an increased risk of bleeding. National guidelines have not made specific recommendations given the lack of adequate data. In choosing the best antithrombotic options for a patient, consideration needs to be given to the risks of stroke, stent thrombosis and major bleeding. This document describes these risks, provides specific recommendations concerning vascular access, stent choice, concomitant use of proton-pump inhibitors and the use and duration of triple therapy following stent placement based upon the risk assessment.

Keywords

Atrial fibrillation - antithrombotic therapy - warfarin - triple therapy - stent

Full Text

References

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Consensus Document: Antithrombotic therapy in patients with atrial fibrillation undergoing coronary stenting[*]

Consensus Document: Antithrombotic therapy in patients with atrial fibrillation undergoing coronary stenting^[*]