title: Antiplatelet and Antithrombotic Therapy in Patients with Atrial Fibrillation Undergoing Coronary Stenting.
abstract: Stroke prevention is the main priority in the management cascade of atrial fibrillation. Most patients require long-term oral anticoagulation (OAC) and may require percutaneous coronary intervention. Prevention of recurrent cardiac ischemia and stent thrombosis necessitate dual antiplatelet therapy (DAPT) for up to 12 months. Triple antithrombotic therapy with OAC plus DAPT of shortest feasible duration is warranted, followed by dual antithrombotic therapy of OAC and antiplatelet agent, and OAC alone after 12 months. Because of elevated risk of hemorrhagic complications, new-generation drug-eluting stents, lower-intensity OAC, radial access, and routine use of gastric protection with proton pump inhibitors are recommended.
authors.affiliation: University of Birmingham Institute of Cardiovascular Sciences, City Hospital, Dudley Road, Birmingham, West Midlands B18 7QH, UK; Department of Internal Medicine I, Grodno State Medical University, Gorkogo 80, Grodno 230009, Belarus.
authors.forename: Mikhail S
authors.initials: MS
authors.lastname: Dzeshka
authors.affiliation: University of Birmingham Institute of Cardiovascular Sciences, City Hospital, Dudley Road, Birmingham, West Midlands B18 7QH, UK.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Brown
authors.affiliation: Cardio-Thoracic-Vascular Department, Ferrarotto Hospital, University of Catania, Via Salvatore Citelli 6, CT 95124, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Capodanno
authors.affiliation: University of Birmingham Institute of Cardiovascular Sciences, City Hospital, Dudley Road, Birmingham, West Midlands B18 7QH, UK; Department of Clinical Medicine, Aalborg Thrombosis Research Unit, Aalborg University, Aalborg Hospital Science and Innovation Center, Søndre Skovvej 15, Aalborg 9100, Denmark. Electronic address: g.y.h.lip@bham.ac.uk.
authors.forename: Gregory Y H
authors.initials: GY
authors.lastname: Lip
mesh_terms: D001281:Atrial Fibrillation / Q000150:complications*; D003324:Coronary Artery Disease / Q000150:complications* / Q000601:surgery; D054855:Drug-Eluting Stents; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D062645:Percutaneous Coronary Intervention; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D013927:Thrombosis / Q000209:etiology / Q000517:prevention & control*
chemical_list: D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors
keywords: Acute coronary syndrome; Antiplatelet therapy; Atrial fibrillation; Coronary artery disease; Oral anticoagulation; Percutaneous coronary intervention; Stenting; Stroke