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Article: Antithrombotic therapy in patients treated with oral anticoagulation undergoing coronary artery stenting. An expert consensus document with focus on atrial fibrillation

TitleAntithrombotic therapy in patients treated with oral anticoagulation undergoing coronary artery stenting. An expert consensus document with focus on atrial fibrillation
Authors
Issue Date2008
PublisherTaylor & Francis A B. The Journal's web site is located at http://www.tandf.co.uk/journals/titles/07853890.html
Citation
Annals Of Medicine, 2008, v. 40 n. 6, p. 428-436 How to Cite?
AbstractDual antiplatelet treatment with aspirin and clopidogrel is recommended after coronary stenting (PCI-S). There is scant evidence defining optimal post-PCI-S antithrombotic therapy in patients with atrial fibrillation (AF) in whom oral anticoagulation (OAC) is mandated. To evaluate the safety and efficacy of the antithrombotic strategies for this population, we conducted a systematic review of the available evidence in patients treated with OAC undergoing PCI-S. AF was the most frequent indication for OAC. Post-PCI-S management was highly variable, and triple therapy with warfarin, aspirin, and clopidogrel was the most frequent and effective combination. Warfarin plus aspirin alone was not sufficiently effective in the early period after PCI-S and should not be prescribed. While acknowledging that the optimal antithrombotic treatment for patients with AF at medium or high thromboembolic risk undergoing PCI-S is currently undefined, triple therapy of warfarin, aspirin, and clopidogrel is currently recommended, although associated with an increased risk of major bleeding. Restrictive use of drug-eluting stent is also recommended, due to the need for prolonged multiple-drug antithrombotic therapy which may increase the bleeding risk. Whether the combination of warfarin and clopidogrel (without aspirin) will preserve efficacy and produce less bleeding is an important issue still needing to be addressed. © 2008 Informa UK Ltd. (Informa Healthcare, Taylor & Francis AS).
Persistent Identifierhttp://hdl.handle.net/10722/163199
ISSN
2015 Impact Factor: 3.763
2015 SCImago Journal Rankings: 1.658
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorRubboli, Aen_US
dc.contributor.authorHalperin, JLen_US
dc.contributor.authorJuhani Airaksinen, KEen_US
dc.contributor.authorBuerke, Men_US
dc.contributor.authorEeckhout, Een_US
dc.contributor.authorFreedman, SBen_US
dc.contributor.authorGershlick, AHen_US
dc.contributor.authorSchlitt, Aen_US
dc.contributor.authorFat Tse, Hen_US
dc.contributor.authorVerheugt, FWAen_US
dc.contributor.authorLip, GYHen_US
dc.date.accessioned2012-09-05T05:28:40Z-
dc.date.available2012-09-05T05:28:40Z-
dc.date.issued2008en_US
dc.identifier.citationAnnals Of Medicine, 2008, v. 40 n. 6, p. 428-436en_US
dc.identifier.issn0785-3890en_US
dc.identifier.urihttp://hdl.handle.net/10722/163199-
dc.description.abstractDual antiplatelet treatment with aspirin and clopidogrel is recommended after coronary stenting (PCI-S). There is scant evidence defining optimal post-PCI-S antithrombotic therapy in patients with atrial fibrillation (AF) in whom oral anticoagulation (OAC) is mandated. To evaluate the safety and efficacy of the antithrombotic strategies for this population, we conducted a systematic review of the available evidence in patients treated with OAC undergoing PCI-S. AF was the most frequent indication for OAC. Post-PCI-S management was highly variable, and triple therapy with warfarin, aspirin, and clopidogrel was the most frequent and effective combination. Warfarin plus aspirin alone was not sufficiently effective in the early period after PCI-S and should not be prescribed. While acknowledging that the optimal antithrombotic treatment for patients with AF at medium or high thromboembolic risk undergoing PCI-S is currently undefined, triple therapy of warfarin, aspirin, and clopidogrel is currently recommended, although associated with an increased risk of major bleeding. Restrictive use of drug-eluting stent is also recommended, due to the need for prolonged multiple-drug antithrombotic therapy which may increase the bleeding risk. Whether the combination of warfarin and clopidogrel (without aspirin) will preserve efficacy and produce less bleeding is an important issue still needing to be addressed. © 2008 Informa UK Ltd. (Informa Healthcare, Taylor & Francis AS).en_US
dc.languageengen_US
dc.publisherTaylor & Francis A B. The Journal's web site is located at http://www.tandf.co.uk/journals/titles/07853890.htmlen_US
dc.relation.ispartofAnnals of Medicineen_US
dc.subject.meshAdministration, Oralen_US
dc.subject.meshAnticoagulants - Administration & Dosageen_US
dc.subject.meshAspirin - Administration & Dosageen_US
dc.subject.meshAtrial Fibrillation - Surgeryen_US
dc.subject.meshDrug Therapy, Combinationen_US
dc.subject.meshHumansen_US
dc.subject.meshMyocardial Revascularizationen_US
dc.subject.meshPostoperative Careen_US
dc.subject.meshStentsen_US
dc.subject.meshThrombosis - Prevention & Controlen_US
dc.subject.meshTiclopidine - Administration & Dosage - Analogs & Derivativesen_US
dc.subject.meshWarfarin - Administration & Dosageen_US
dc.titleAntithrombotic therapy in patients treated with oral anticoagulation undergoing coronary artery stenting. An expert consensus document with focus on atrial fibrillationen_US
dc.typeArticleen_US
dc.identifier.emailFat Tse, H:hftse@hkucc.hku.hken_US
dc.identifier.authorityFat Tse, H=rp00428en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1080/07853890802089786en_US
dc.identifier.pmid18608125-
dc.identifier.scopuseid_2-s2.0-51049096996en_US
dc.identifier.hkuros160261-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-51049096996&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume40en_US
dc.identifier.issue6en_US
dc.identifier.spage428en_US
dc.identifier.epage436en_US
dc.identifier.isiWOS:000258805200003-
dc.publisher.placeSwedenen_US
dc.identifier.scopusauthoridRubboli, A=7003890019en_US
dc.identifier.scopusauthoridHalperin, JL=7102699317en_US
dc.identifier.scopusauthoridJuhani Airaksinen, KE=6602301327en_US
dc.identifier.scopusauthoridBuerke, M=7004165339en_US
dc.identifier.scopusauthoridEeckhout, E=7006130838en_US
dc.identifier.scopusauthoridFreedman, SB=35481156500en_US
dc.identifier.scopusauthoridGershlick, AH=7005330722en_US
dc.identifier.scopusauthoridSchlitt, A=6603066282en_US
dc.identifier.scopusauthoridFat Tse, H=7006070805en_US
dc.identifier.scopusauthoridVerheugt, FWA=35379802700en_US
dc.identifier.scopusauthoridLip, GYH=35351259800en_US

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