title: Triple antithrombotic therapy in cardiac patients: more questions than answers.
abstract: Many cardiac patients require combined antithrombotic therapy consisting of an anticoagulant and inhibition of platelet function. The most frequent indications are atrial fibrillation (AF) in combination with drug-eluting stent implantation and/or the presence of an acute coronary syndrome (ACS). Currently, the optimal combination of anticoagulants and anti-platelet therapy is unknown, but it is well established that the combination of regular doses and regimens as prescribed in AF or after ACS results in increased bleeding rates. In this review, we discuss the current literature and describe approaches to reduce the risk of bleeding hoping not to increase the rate of ischaemic events.
authors.affiliation: Heart Center, Cardiology and Angiology I, Freiburg University, Hugstetter Strasse 55, Freiburg 79106, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Moser
authors.forename: Christoph B
authors.initials: CB
authors.lastname: Olivier
authors.forename: Christoph
authors.initials: C
authors.lastname: Bode
mesh_terms: D000284:Administration, Oral; D000925:Anticoagulants / Q000008:administration & dosage; D002318:Cardiovascular Diseases / Q000188:drug therapy*; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D054855:Drug-Eluting Stents; D004617:Embolism / Q000517:prevention & control; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006083:Graft Occlusion, Vascular / Q000517:prevention & control; D006470:Hemorrhage / Q000517:prevention & control; D006801:Humans; D062645:Percutaneous Coronary Intervention; D017410:Practice Guidelines as Topic; D057285:Precision Medicine; D058921:Purinergic P2Y Receptor Antagonists / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D020521:Stroke / Q000517:prevention & control; D014812:Vitamin K / Q000037:antagonists & inhibitors
chemical_list: D000925:Anticoagulants; D005343:Fibrinolytic Agents; D058921:Purinergic P2Y Receptor Antagonists; D014812:Vitamin K
keywords: Acute coronary syndrome; Antithrombotic therapy; Atrial fibrillation; Platelets; Triple therapy