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Thromb Haemost 2011; 106(04): 571-584
DOI: 10.1160/TH11-04-0262
Consensus Document
Schattauer GmbH

Consensus Document: Antithrombotic therapy in patients with atrial fibrillation undergoing coronary stenting[*]

A North-American perspective
David P. Faxon
1   Division of Cardiology, Brigham and Women’s Hospital, Boston, Massachusetts, USA
,
John W. Eikelboom
2   Department of Medicine, Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada
,
Peter B. Berger
3   Geisinger Clinic, Danville, Pennsylvania, USA
,
David R. Holmes
4   Mayo Clinic, Rochester, Minnesota, USA
,
Deepak L. Bhatt
5   Division of Cardiology, VA Boston Health System, Boston, Massachusetts, USA
,
David J. Moliterno
6   Gill Heart Institute and Division of Cardiovascular Medicine, University of Kentucky, Lexington, Kentucky, USA
,
Richard C. Becker
7   Divisions of Cardiology and Hematology, Duke University School of Medicine, Durham, North Carolina, USA
,
Dominick J. Angiolill
8   Division of Cardiology, University of Florida College of Medicine-Jacksonville, Jacksonville, Florida, USA
› Author Affiliations
Further Information

Publication History

Received: 21 April 2011

Accepted after major revision: 05 July 2011

Publication Date:
15 December 2017 (online)

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Summary

The optimal regimen of the anticoagulant and antiplatelet therapies in patients with atrial fibrillation who have had a coronary stent is unclear. It is well recognised that “triple therapy” with aspirin, clopidogrel, and warfarin is associated with an increased risk of bleeding. National guidelines have not made specific recommendations given the lack of adequate data. In choosing the best antithrombotic options for a patient, consideration needs to be given to the risks of stroke, stent thrombosis and major bleeding. This document describes these risks, provides specific recommendations concerning vascular access, stent choice, concomitant use of proton-pump inhibitors and the use and duration of triple therapy following stent placement based upon the risk assessment.

Keywords

Atrial fibrillation - antithrombotic therapy - warfarin - triple therapy - stent

* An Executive Summary of this article will be published in the journal Circulation: Cardiovascular Interventions.


 

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