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Evolving paradigms in antithrombotic therapy for anticoagulated patients undergoing coronary stenting
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.ORCID iD: 0000-0002-7767-3073
Division of Cardiology, University of Florida College of Medicine, Jacksonville, FL, USA.ORCID iD: 0000-0001-8451-2131
Division of Cardiology, C.A.S.T., P.O. ‘G. Rodolico,’ Azienda Ospedaliero-Universitaria ‘Policlinico-Vittorio Emanuele,’ P.O. Rodolico, Ed. 8, Via Santa Sofia 78, Catania, Sicilia, Italy.
2019 (English)In: Therapeutic advances in cardiovascular disease, ISSN 1753-9455, Vol. 13, article id 1753944719891688Article, review/survey (Refereed) Published
Abstract [en]

A sizable proportion of coronary artery disease (CAD) patients undergoing percutaneous coronary intervention (PCI) with stent implantation have an indication for treatment with oral anticoagulant therapy (OAC). The coexistence of atrial fibrillation (AF) and the need for PCI expose patients to a higher risk of developing thrombotic complications, and a multitargeted antithrombotic treatment strategy, addressing both platelet- and coagulation-mediated triggering mechanisms of thrombosis, is necessary for ensuring full protection from ischemic hazards. The increased bleeding risk identified with triple antithrombotic therapy has driven the search for alternative treatment modalities and pharmacological combination strategies aimed at achieving an optimal balance between safety and efficacy in this complex clinical scenario. Over a short time period, the paradigms surrounding the management of patients undergoing PCI who require OAC have substantially evolved. In this review, we summarize and critically evaluate the results of recent randomized clinical trials investigating the pharmacological management of patients who, in addition to antiplatelet therapy, have an indication for OAC treatment before or at the time of a PCI procedure.

Place, publisher, year, edition, pages
Sage Publications, 2019. Vol. 13, article id 1753944719891688
Keywords [en]
Antithrombotic therapy, Atrial fibrillation, Bleeding, Percutaneous coronary intervention, Stent thrombosis, Stroke
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:uu:diva-401384DOI: 10.1177/1753944719891688ISI: 000501887400001PubMedID: 31814532OAI: oai:DiVA.org:uu-401384DiVA, id: diva2:1383312
Available from: 2020-01-07 Created: 2020-01-07 Last updated: 2020-01-10Bibliographically approved

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