Consensus Document: Antithrombotic therapy in patients with atrial fibrillation undergoing coronary stenting A North-American perspective

被引:167
作者
Faxon, David P. [1 ]
Eikelboom, John W. [2 ,3 ]
Berger, Peter B. [4 ]
Holmes, David R. [5 ]
Bhatt, Deepak L. [6 ]
Moliterno, David J. [7 ,8 ]
Becker, Richard C. [9 ,10 ]
Angiolillo, Dominick J. [11 ]
机构
[1] Brigham & Womens Hosp, Div Cardiol, Boston, MA 02120 USA
[2] Hamilton Hlth Sci, Dept Med, Hamilton, ON, Canada
[3] McMaster Univ, Hamilton, ON, Canada
[4] Weis Ctr Res, Geisinger Clin, Danville, PA 17822 USA
[5] Mayo Clin, Rochester, MN USA
[6] VA Boston Hlth Syst, Div Cardiol, Boston, MA USA
[7] Univ Kentucky, Gill Heart Inst, Lexington, KY USA
[8] Univ Kentucky, Div Cardiovasc Med, Lexington, KY USA
[9] Duke Univ, Sch Med, Div Cardiol, Durham, NC USA
[10] Duke Univ, Sch Med, Div Hematol, Durham, NC USA
[11] Univ Florida, Div Cardiol, Coll Med Jacksonville, Jacksonville, FL USA
关键词
Atrial fibrillation; antithrombotic therapy; warfarin; triple therapy; stent; DUAL ANTIPLATELET THERAPY; ACCF/AHA/HRS FOCUSED UPDATE; CARDIOLOGY WORKING GROUP; RHYTHM ASSOCIATION EHRA; PROTON-PUMP INHIBITORS; LOW-DOSE ASPIRIN; ELUTING STENT; BARE-METAL; MYOCARDIAL-INFARCTION; ORAL ANTICOAGULANT;
D O I
10.1160/TH11-04-0262
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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.
引用
收藏
页码:572 / 584
页数:13
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