Antithrombotic Therapy in Patients With Atrial Fibrillation Undergoing Coronary Stenting A North American Perspective: Executive Summary

被引:80
作者
Faxon, David P. [1 ]
Eikelboom, John W. [2 ,3 ]
Berger, Peter B. [4 ]
Holmes, David R., Jr. [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, Coll Med Jacksonville, Div Cardiol, Jacksonville, FL USA
关键词
atrial fibrillation; antithrombotic therapy; warfarin; triple therapy; stent; DUAL ANTIPLATELET THERAPY; ASSOCIATION TASK-FORCE; ACCF/AHA/HRS FOCUSED UPDATE; CARDIOLOGY WORKING GROUP; PROTON-PUMP INHIBITORS; LOW-DOSE ASPIRIN; ELUTING STENT; MYOCARDIAL-INFARCTION; BARE-METAL; ORAL ANTICOAGULANT;
D O I
10.1161/CIRCINTERVENTIONS.111.965186
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 recognized 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 executive summary 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 after stent placement, based on the risk assessment. (Circ Cardiovasc Interv. 2011;4:522-534.)
引用
收藏
页码:522 / 534
页数:13
相关论文
共 99 条
[1]   ACCF/ACG/AHA 2010 Expert Consensus Document on the Concomitant Use of Proton Pump Inhibitors and Thienopyridines: A Focused Update of the ACCF/ACG/AHA 2008 Expert Consensus Document on Reducing the Gastrointestinal Risks of Antiplatelet Therapy and NSAID Use A Report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents [J].
Abraham, Neena S. ;
Hlatky, Mark A. ;
Antman, Elliott M. ;
Bhatt, Deepak L. ;
Bjorkman, David J. ;
Clark, Craig B. ;
Furberg, Curt D. ;
Johnson, David A. ;
Kahi, Charles J. ;
Laine, Loren ;
Mahaffey, Kenneth W. ;
Quigley, Eamonn M. ;
Scheiman, James ;
Sperling, Laurence S. ;
Tomaselli, Gordon F. ;
Harrington, Robert A. ;
Bates, Eric R. ;
Bhatt, Deepak L. ;
Ferrari, Victor A. ;
Fisher, John D. ;
Gardner, Timothy J. ;
Gentile, Federico ;
Hlatky, Mark A. ;
Jacobs, Alice K. ;
Kaul, Sanjay ;
Moliterno, David J. ;
Weitz, Howard H. ;
Wesley, Deborah J. .
CIRCULATION, 2010, 122 (24) :2619-2633
[2]   New oral anticoagulant drugs in cardiovascular disease [J].
Ahrens, Ingo ;
Lip, Gregory Y. H. ;
Peter, Karlheinz .
THROMBOSIS AND HAEMOSTASIS, 2010, 104 (01) :49-60
[3]   Incidence and predictors of drug-eluting stent thrombosis during and after discontinuation of thienopyridine treatment [J].
Airoldi, Flavio ;
Colombo, Antonio ;
Morici, Nuccia ;
Latib, Azeem ;
Cosgrave, John ;
Buellesfeld, Lutz ;
Bonizzoni, Erminio ;
Carlino, Mauro ;
Gerckens, Ulrich ;
Godino, Cosmo ;
Melzi, Gloria ;
Michev, Iassen ;
Montorfano, Matteo ;
Sangiorgi, Giuseppe Massimo ;
Qasim, Asif ;
Chieffo, Alaide ;
Briguori, Carlo ;
Grube, Eberhard .
CIRCULATION, 2007, 116 (07) :745-754
[4]   Apixaban, an Oral, Direct, Selective Factor Xa Inhibitor, in Combination With Antiplatelet Therapy After Acute Coronary Syndrome Results of the Apixaban for Prevention of Acute Ischemic and Safety Events (APPRAISE) Trial [J].
Alexander, John H. ;
Becker, Richard C. ;
Bhatt, Deepak L. ;
Cools, Frank ;
Crea, Filippo ;
Dellborg, Mikael ;
Fox, Keith A. A. ;
Goodman, Shaun G. ;
Harrington, Robert A. ;
Huber, Kurt ;
Husted, Steen ;
Lewis, Basil S. ;
Lopez-Sendon, Jose ;
Mohan, Puneet ;
Montalescot, Gilles ;
Ruda, Mikhail ;
Ruzyllo, Witold ;
Verheugt, Freek ;
Wallentin, Lars ;
Darius, Harald ;
Simoons, Maarten ;
Boersma, Eric ;
DeLemos, James ;
Spencer, Fred .
CIRCULATION, 2009, 119 (22) :2877-U39
[5]   Patient, Heal Thyself: The Ongoing Evolution of Patient Self-directed Care and Hand-Held Technology [J].
Anaya, Paul ;
Moliterno, David J. .
ANNALS OF INTERNAL MEDICINE, 2011, 154 (07)
[6]   Randomized trial of genotype-guided versus standard warfarin dosing in patients initiating oral anticoagulation [J].
Anderson, Jeffrey L. ;
Horne, Benjamin D. ;
Stevens, Scott M. ;
Grove, Amanda S. ;
Barton, Stephanie ;
Nicholas, Zachery P. ;
Kahn, Samera F. S. ;
May, Heidi T. ;
Samuelson, Kent M. ;
Muhlestein, Joseph B. ;
Carlquist, John F. .
CIRCULATION, 2007, 116 (22) :2563-2570
[7]   2011 ACCF/AHA Focused Update Incorporated Into the ACC/AHA 2007 Guidelines for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines [J].
Anderson, Jeffrey L. ;
Adams, Cynthia D. ;
Antman, Elliott M. ;
Bridges, Charles R. ;
Califf, Robert M. ;
Casey, Donald E., Jr. ;
Chavey, William E., II ;
Fesmire, Francis M. ;
Hochman, Judith S. ;
Levin, Thomas N. ;
Lincoff, A. Michael ;
Peterson, Eric D. ;
Theroux, Pierre ;
Wenger, Nanette Kass ;
Wright, R. Scott ;
Ettinger, Steven M. ;
Ganiats, Theodore G. ;
Jneid, Hani ;
Philippides, George J. ;
Zidar, James Patrick ;
Jacobs, Alice K. ;
Albert, Nancy ;
Hochman, Judith S. ;
Creager, Mark A. ;
Kushner, Frederick G. ;
Ohman, Erik Magnus ;
Guyton, Robert A. ;
Stevenson, William G. ;
Halperin, Jonathan L. ;
Yancy, Clyde W. .
CIRCULATION, 2011, 123 (18) :E426-E579
[8]   Differential Effects of Omeprazole and Pantoprazole on the Pharmacodynamics and Pharmacokinetics of Clopidogrel in Healthy Subjects: Randomized, Placebo-Controlled, Crossover Comparison Studies [J].
Angiolillo, D. J. ;
Gibson, C. M. ;
Cheng, S. ;
Ollier, C. ;
Nicolas, O. ;
Bergougnan, L. ;
Perrin, L. ;
LaCreta, F. P. ;
Hurbin, F. ;
Dubar, M. .
CLINICAL PHARMACOLOGY & THERAPEUTICS, 2011, 89 (01) :65-74
[9]   Randomized comparison of a high clopidogrel maintenance dose in patients with diabetes mellitus and coronary artery disease - Results of the Optimizing antiPlatelet Therapy In diabetes MellitUS (OPTIMUS) study [J].
Angiolillo, Dominick J. ;
Shoemaker, Steven B. ;
Desai, Bhaloo ;
Yuan, Hang ;
Charlton, Ronald K. ;
Bernardo, Esther ;
Zenni, Martin M. ;
Guzman, Luis A. ;
Bass, Theodore A. ;
Costa, Marco A. .
CIRCULATION, 2007, 115 (06) :708-716
[10]   Variability in individual responsiveness to clopidogrel - Clinical implications, management, and future perspectives [J].
Angiolillo, Dominick J. ;
Fernandez-Ortiz, Antonio ;
Bernardo, Esther ;
Alfonso, Fernando ;
Macaya, Carlos ;
Bass, Theodore A. ;
Costa, Marco A. .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2007, 49 (14) :1505-1516