title: Antithrombotic treatment in anticoagulated atrial fibrillation patients undergoing percutaneous coronary intervention.
abstract: Coronary artery disease coexists in a clinically relevant number of patients with atrial fibrillation and it often requires percutaneous coronary intervention. These patients represent a particular challenge for clinicians in terms of antithrombotic management. They require combined antiplatelet-anticoagulant therapy to reduce the risk of recurrent ischemic cardiac events and stroke; however, this antithrombotic strategy is associated with an increased risk of bleeding complications. In the absence of randomized, controlled clinical trials, the majority of current recommendations rely on the results of cohort studies, meta-analyses, post-hoc analyses and subgroup analyses of large, phase III studies. Based on the available evidence, the present review discusses the optimal antithrombotic strategy for patients receiving chronic anticoagulant therapy due to atrial fibrillation who require antiplatelet treatment after acute coronary syndrome and/or percutaneous coronary intervention, and discusses the issue of dental procedures. The correct planning of therapy significantly reduces the risk of bleeding complications and thromboembolic events.
  
  
  CONCLUSIONS
  In order to reduce the occurrence of recurrent cardiac ischemic events and stroke, anticoagulated patients with acute coronary syndrome and/or percutaneous coronary intervention require a combination of therapies including anticoagulants and antiplatelet drugs. Using the newest optimal combination of therapeutic strategies reduces the risk of haemorrhagic complications.
authors.affiliation: Petz Aladár County Teaching Hospital, Department of Cardiology, 2-4 Vasvári P. str., 9024 Győr, Hungary. Electronic address: dcsa62@gmail.com.
authors.forename: Csaba András
authors.initials: CA
authors.lastname: Dézsi
authors.affiliation: Private Practice, SolyDent Dentist's Office, 24/b. Kálvária str., 9024 Győr, Hungary.
authors.forename: Balázs Bence
authors.initials: BB
authors.lastname: Dézsi
authors.affiliation: Invasive Cardiology Unit, Heart Center Balatonfüred, 2 Gyógy sq., 8230 Balatonfüred, Hungary.
authors.forename: Döme András
authors.initials: DA
authors.lastname: Dézsi
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications* / Q000601:surgery; D000925:Anticoagulants / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy*; D001777:Blood Coagulation; D006470:Hemorrhage / Q000517:prevention & control; D006801:Humans; D062645:Percutaneous Coronary Intervention; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D020521:Stroke / Q000517:prevention & control; D013923:Thromboembolism / Q000517:prevention & control
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors
keywords: Acute coronary syndrome; Anticoagulants; Atrial fibrillation; Dental procedures; Direct-acting oral anticoagulants; Dual antiplatelet therapy; Percutaneous coronary intervention