Skip to main content
Erschienen in: Current Cardiology Reports 8/2015

01.08.2015 | New Therapies for Cardiovascular Disease (KW Mahaffey, Section Editor)

Antiplatelet Therapy During PCI for Patients with Stable Angina and Atrial Fibrillation

verfasst von: Amjid Iqbal, Fatima Rodriguez, Henrik Schirmer

Erschienen in: Current Cardiology Reports | Ausgabe 8/2015

Einloggen, um Zugang zu erhalten

Abstract

The pharmacological treatment options for anticoagulation in patients with atrial fibrillation (Afib) have increased with the introduction of novel oral anticoagulants, compared with earlier times, when vitamin K antagonist was the drug of choice. As they age, many Afib patients require percutaneous coronary intervention (PCI), necessitating antiplatelet medication in addition to anticoagulation therapy. Choosing the appropriate combination and duration of anticoagulation and antiplatelet therapies may be challenging in stable coronary artery disease (CAD) and even more complicated during and after coronary intervention with the introduction of additional antithrombotic drugs. In this article, we review the scientific basis for the recent guidelines for anticoagulation and antithrombotic therapy in patients with Afib and stable CAD before, during, and after elective PCI.
Literatur
1.
Zurück zum Zitat Chugh SS, Roth GA, Gillum RF, Mensah GA. Global burden of atrial fibrillation in developed and developing nations. Glob Heart. 2014;9(1):113–9.PubMedCrossRef Chugh SS, Roth GA, Gillum RF, Mensah GA. Global burden of atrial fibrillation in developed and developing nations. Glob Heart. 2014;9(1):113–9.PubMedCrossRef
2.
Zurück zum Zitat National Clinical Guideline Centre (UK). Atrial Fibrillation. The management of atrial fibrillation. London: National Institute for Health and Care Excellence (UK). London: National Institute for Health and Care Excellence (UK); 2014. National Clinical Guideline Centre (UK). Atrial Fibrillation. The management of atrial fibrillation. London: National Institute for Health and Care Excellence (UK). London: National Institute for Health and Care Excellence (UK); 2014.
3.
Zurück zum Zitat Reiffel JA. Atrial fibrillation and stroke: epidemiology. Am J Med. 2014;127(4):e15–6. Reiffel JA. Atrial fibrillation and stroke: epidemiology. Am J Med. 2014;127(4):e15–6.
4.
Zurück zum Zitat Kim MH, Johnston SS, Chu BC, et al. Estimation of total incremental health care costs in patients with atrial fibrillation in the United States. Circ Cardiovasc Qual Outcomes. 2011;4(3):313–20.PubMedCrossRef Kim MH, Johnston SS, Chu BC, et al. Estimation of total incremental health care costs in patients with atrial fibrillation in the United States. Circ Cardiovasc Qual Outcomes. 2011;4(3):313–20.PubMedCrossRef
6.
Zurück zum Zitat Lip GY, Laroche C, Dan GA, et al. ‘Real-world’ antithrombotic treatment in atrial fibrillation: The EORP-AF pilot survey. Am J Med. 2014;127(6):519–29.PubMedCrossRef Lip GY, Laroche C, Dan GA, et al. ‘Real-world’ antithrombotic treatment in atrial fibrillation: The EORP-AF pilot survey. Am J Med. 2014;127(6):519–29.PubMedCrossRef
7.••
Zurück zum Zitat Camm AJ, Lip GY, De Caterina R, et al. 2012 focused update of the ESC Guidelines for the management of atrial fibrillation: an update of the 2010 ESC Guidelines for the management of atrial fibrillation. Developed with the special contribution of the European Heart Rhythm Association. Eur Heart J. 2012;33(21):2719–47. These clinical guidelines present evidence for why and how to choose anticoagulant therapy for patients with Afib and provide a good overview of rate vs. rhythm control strategies.PubMedCrossRef Camm AJ, Lip GY, De Caterina R, et al. 2012 focused update of the ESC Guidelines for the management of atrial fibrillation: an update of the 2010 ESC Guidelines for the management of atrial fibrillation. Developed with the special contribution of the European Heart Rhythm Association. Eur Heart J. 2012;33(21):2719–47. These clinical guidelines present evidence for why and how to choose anticoagulant therapy for patients with Afib and provide a good overview of rate vs. rhythm control strategies.PubMedCrossRef
8.
Zurück zum Zitat January CT, Wann LS, Alpert JS, et al. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association task force on practice guidelines and the Heart Rhythm Society. J Am Coll Cardiol. 2014;64(21):e1–e76.PubMedCrossRef January CT, Wann LS, Alpert JS, et al. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association task force on practice guidelines and the Heart Rhythm Society. J Am Coll Cardiol. 2014;64(21):e1–e76.PubMedCrossRef
9.
Zurück zum Zitat Kralev S, Schneider K, Lang S, et al. Incidence and severity of coronary artery disease in patients with atrial fibrillation undergoing first-time coronary angiography. PLoS One. 2011;6(9):e24964.PubMedCentralPubMedCrossRef Kralev S, Schneider K, Lang S, et al. Incidence and severity of coronary artery disease in patients with atrial fibrillation undergoing first-time coronary angiography. PLoS One. 2011;6(9):e24964.PubMedCentralPubMedCrossRef
10.•
Zurück zum Zitat Pastori D, Pignatelli P, Angelico F, et al. Incidence of myocardial infarction and vascular death in anticoagulated elderly patients with atrial fibrillation: relation to atherosclerotic risk factors. Chest. 2014. doi:10.1378/chest.14-2414. This article provides a good overview of the risk associated with having Afib. Pastori D, Pignatelli P, Angelico F, et al. Incidence of myocardial infarction and vascular death in anticoagulated elderly patients with atrial fibrillation: relation to atherosclerotic risk factors. Chest. 2014. doi:10.​1378/​chest.​14-2414. This article provides a good overview of the risk associated with having Afib.
11.••
Zurück zum Zitat Lip GYH, Windecker S, Huber K, et al. Management of antithrombotic therapy in atrial fibrillation patients presenting with acute coronary syndrome and/or undergoing percutaneous coronary or valve interventions: a joint consensus document of the European Society of Cardiology Working Group on…. 2014. Eur Heart J. 2014;35(45):3155–79. These updated guidelines provide comprehensive recommendations for choosing treatment for patients with Afib in need of both OAC and PCI. The article also highlights the unanswered questions in this field that need to be addressed in future clinical trials.PubMedCrossRef Lip GYH, Windecker S, Huber K, et al. Management of antithrombotic therapy in atrial fibrillation patients presenting with acute coronary syndrome and/or undergoing percutaneous coronary or valve interventions: a joint consensus document of the European Society of Cardiology Working Group on…. 2014. Eur Heart J. 2014;35(45):3155–79. These updated guidelines provide comprehensive recommendations for choosing treatment for patients with Afib in need of both OAC and PCI. The article also highlights the unanswered questions in this field that need to be addressed in future clinical trials.PubMedCrossRef
12.•
Zurück zum Zitat Lane DA, Lip GYH. Use of the CHA2DS2-VASc and HAS-BLED scores to aid decision making for thromboprophylaxis in nonvalvular atrial fibrillation. Circulation. 2012;126(7):860–5. This article presents evidence for use of the CHA2DS2-VASc and HAS-BLED scoring systems as well as guidance on how to use these risk calculators.PubMedCrossRef Lane DA, Lip GYH. Use of the CHA2DS2-VASc and HAS-BLED scores to aid decision making for thromboprophylaxis in nonvalvular atrial fibrillation. Circulation. 2012;126(7):860–5. This article presents evidence for use of the CHA2DS2-VASc and HAS-BLED scoring systems as well as guidance on how to use these risk calculators.PubMedCrossRef
13.
Zurück zum Zitat Lip GY, Nieuwlaat R, Pisters R, et al. Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: the Euro Heart Survey on atrial fibrillation. Chest. 2010;137(2):263–72.PubMedCrossRef Lip GY, Nieuwlaat R, Pisters R, et al. Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: the Euro Heart Survey on atrial fibrillation. Chest. 2010;137(2):263–72.PubMedCrossRef
14.
Zurück zum Zitat Pisters R, Lane DA, Nieuwlaat R, et al. A novel user-friendly score (HAS-BLED) to assess 1-year risk of major bleeding in patients with atrial fibrillation: the Euro Heart Survey. Chest. 2010;138(5):1093–100.PubMedCrossRef Pisters R, Lane DA, Nieuwlaat R, et al. A novel user-friendly score (HAS-BLED) to assess 1-year risk of major bleeding in patients with atrial fibrillation: the Euro Heart Survey. Chest. 2010;138(5):1093–100.PubMedCrossRef
15.
Zurück zum Zitat Olesen JB, Lip GYH, Lindhardsen J, et al. Risks of thromboembolism and bleeding with thromboprophylaxis in patients with atrial fibrillation: a net clinical benefit analysis using a ‘real world’ nationwide cohort study. Thromb Haemost. 2011;106(4):739–49.PubMedCrossRef Olesen JB, Lip GYH, Lindhardsen J, et al. Risks of thromboembolism and bleeding with thromboprophylaxis in patients with atrial fibrillation: a net clinical benefit analysis using a ‘real world’ nationwide cohort study. Thromb Haemost. 2011;106(4):739–49.PubMedCrossRef
16.
Zurück zum Zitat Hart RG, Pearce LA, Aguilar MI. Meta-analysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation. Ann Intern Med. 2007;146(12):857–67.PubMedCrossRef Hart RG, Pearce LA, Aguilar MI. Meta-analysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation. Ann Intern Med. 2007;146(12):857–67.PubMedCrossRef
17.
Zurück zum Zitat Aguilar M, Hart R. Antiplatelet therapy for preventing stroke in patients with non-valvular atrial fibrillation and no previous history of stroke or transient ischemic attacks. Cochrane database of systematic reviews (Online). Cochrane Database Syst Rev. 200; (4):CD001925. Aguilar M, Hart R. Antiplatelet therapy for preventing stroke in patients with non-valvular atrial fibrillation and no previous history of stroke or transient ischemic attacks. Cochrane database of systematic reviews (Online). Cochrane Database Syst Rev. 200; (4):CD001925.
18.
Zurück zum Zitat Connolly S, Pogue J, Hart R, et al. Clopidogrel plus aspirin versus oral anticoagulation for atrial fibrillation in the Atrial fibrillation Clopidogrel Trial with Irbesartan for prevention of Vascular Events (ACTIVE W): a randomised controlled trial. Lancet. 2006;367(9526):1903–12.PubMedCrossRef Connolly S, Pogue J, Hart R, et al. Clopidogrel plus aspirin versus oral anticoagulation for atrial fibrillation in the Atrial fibrillation Clopidogrel Trial with Irbesartan for prevention of Vascular Events (ACTIVE W): a randomised controlled trial. Lancet. 2006;367(9526):1903–12.PubMedCrossRef
19.
Zurück zum Zitat Petersen P, Boysen G, Godtfredsen J, et al. Placebo-controlled, randomised trial of warfarin and aspirin for prevention of thromboembolic complications in chronic atrial fibrillation. The Copenhagen AFASAK study. Lancet. 1989;1(8631):175–9.PubMedCrossRef Petersen P, Boysen G, Godtfredsen J, et al. Placebo-controlled, randomised trial of warfarin and aspirin for prevention of thromboembolic complications in chronic atrial fibrillation. The Copenhagen AFASAK study. Lancet. 1989;1(8631):175–9.PubMedCrossRef
20.
Zurück zum Zitat Ogilvie IM1, Newton N, Welner SA, et al. Underuse of oral anticoagulants in atrial fibrillation: a systematic review. Am J Med. 2010;123(7):638–645.e4.PubMedCrossRef Ogilvie IM1, Newton N, Welner SA, et al. Underuse of oral anticoagulants in atrial fibrillation: a systematic review. Am J Med. 2010;123(7):638–645.e4.PubMedCrossRef
21.
Zurück zum Zitat Connolly SJ, Ezekowitz MD, Yusuf S, et al. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med. 2009;361(12):1139–51.PubMedCrossRef Connolly SJ, Ezekowitz MD, Yusuf S, et al. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med. 2009;361(12):1139–51.PubMedCrossRef
22.
Zurück zum Zitat Patel MR, Mahaffey KW, Garg J, et al. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med. 2011;365(10):883–91.PubMedCrossRef Patel MR, Mahaffey KW, Garg J, et al. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med. 2011;365(10):883–91.PubMedCrossRef
23.
Zurück zum Zitat Granger CB, Alexander JH, McMurray JJ, Lopes RD, Hylek EM, Hanna M, et al. Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med. 2011;365(11):981–92.PubMedCrossRef Granger CB, Alexander JH, McMurray JJ, Lopes RD, Hylek EM, Hanna M, et al. Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med. 2011;365(11):981–92.PubMedCrossRef
24.
Zurück zum Zitat Giugliano RP, Ruff CT, Braunwald E, et al. Edoxaban versus warfarin in patients with atrial fibrillation. N Engl J Med. 2013;369(22):2093–104.PubMedCrossRef Giugliano RP, Ruff CT, Braunwald E, et al. Edoxaban versus warfarin in patients with atrial fibrillation. N Engl J Med. 2013;369(22):2093–104.PubMedCrossRef
25.
Zurück zum Zitat Dans AL, Connolly SJ, Wallentin L, et al. Concomitant use of antiplatelet therapy with dabigatran or warfarin in the Randomized Evaluation of Long-Term Anticoagulation Therapy (RE-LY) trial. Circulation. 2013;127(5):634–40.PubMedCrossRef Dans AL, Connolly SJ, Wallentin L, et al. Concomitant use of antiplatelet therapy with dabigatran or warfarin in the Randomized Evaluation of Long-Term Anticoagulation Therapy (RE-LY) trial. Circulation. 2013;127(5):634–40.PubMedCrossRef
26.•
Zurück zum Zitat Ruff CT, Giugliano RP, Braunwald E, et al. Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials. Lancet. 2014;383(9921):955–62. This meta-analysis provides data showing the safety and benefit of using the four classes of NOACs, demonstrating greater efficacy and a more favorable risk profile compared with warfarin.PubMedCrossRef Ruff CT, Giugliano RP, Braunwald E, et al. Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials. Lancet. 2014;383(9921):955–62. This meta-analysis provides data showing the safety and benefit of using the four classes of NOACs, demonstrating greater efficacy and a more favorable risk profile compared with warfarin.PubMedCrossRef
27.
Zurück zum Zitat Baigent C, Blackwell L, Collins R, et al. Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomised trials. Lancet. 2009;373(9678):1849–60.PubMedCrossRef Baigent C, Blackwell L, Collins R, et al. Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomised trials. Lancet. 2009;373(9678):1849–60.PubMedCrossRef
28.
Zurück zum Zitat Gent M, Beaumont D, Blanchard J, et al. A randomised, blinded, trial of clopidogrel versus aspirin in patients at risk of ischaemic events (CAPRIE). CAPRIE Steering Committee. Lancet. 1996;348(9038):1329–39.CrossRef Gent M, Beaumont D, Blanchard J, et al. A randomised, blinded, trial of clopidogrel versus aspirin in patients at risk of ischaemic events (CAPRIE). CAPRIE Steering Committee. Lancet. 1996;348(9038):1329–39.CrossRef
29.
Zurück zum Zitat Bhatt DL, Flather MD, Hacke W, et al. Patients with prior myocardial infarction, stroke, or symptomatic peripheral arterial disease in the CHARISMA trial. J Am Coll Cardiol. 2007;49(19):1982–8.PubMedCrossRef Bhatt DL, Flather MD, Hacke W, et al. Patients with prior myocardial infarction, stroke, or symptomatic peripheral arterial disease in the CHARISMA trial. J Am Coll Cardiol. 2007;49(19):1982–8.PubMedCrossRef
30.
Zurück zum Zitat Hurlen M, Abdelnoor M, Smith P, et al. Warfarin, aspirin, or both after myocardial infarction. N Engl J Med. 2002;347(13):969–74.PubMedCrossRef Hurlen M, Abdelnoor M, Smith P, et al. Warfarin, aspirin, or both after myocardial infarction. N Engl J Med. 2002;347(13):969–74.PubMedCrossRef
31.
Zurück zum Zitat Smith P, Arnesen H, Holme I. The effect of warfarin on mortality and reinfarction after myocardial infarction. N Engl J Med. 1990;323(3):147–52.PubMedCrossRef Smith P, Arnesen H, Holme I. The effect of warfarin on mortality and reinfarction after myocardial infarction. N Engl J Med. 1990;323(3):147–52.PubMedCrossRef
32.
Zurück zum Zitat Alexander JH, Lopes RD, James S, et al. Apixaban with antiplatelet therapy after acute coronary syndrome. N Engl J Med. 2011;365(8):699–708.PubMedCrossRef Alexander JH, Lopes RD, James S, et al. Apixaban with antiplatelet therapy after acute coronary syndrome. N Engl J Med. 2011;365(8):699–708.PubMedCrossRef
33.
Zurück zum Zitat Lane DA, Raichand S, Moore D, et al. Combined anticoagulation and antiplatelet therapy for high-risk patients with atrial fibrillation: a systematic review. Health Technol Assess. 2013;17(30):1–188.PubMedCrossRef Lane DA, Raichand S, Moore D, et al. Combined anticoagulation and antiplatelet therapy for high-risk patients with atrial fibrillation: a systematic review. Health Technol Assess. 2013;17(30):1–188.PubMedCrossRef
34.
Zurück zum Zitat Levine GN, Bates ER, Blankenship JC, et al. 2011 ACCF/AHA/SCAI guideline for percutaneous coronary intervention: a report of the American College of Cardiology Foundation/American Heart Association task force on practice guidelines and the society for cardiovascular angiography and interventions. Circulation. 2011;124(23):e574–651.PubMedCrossRef Levine GN, Bates ER, Blankenship JC, et al. 2011 ACCF/AHA/SCAI guideline for percutaneous coronary intervention: a report of the American College of Cardiology Foundation/American Heart Association task force on practice guidelines and the society for cardiovascular angiography and interventions. Circulation. 2011;124(23):e574–651.PubMedCrossRef
35.
Zurück zum Zitat Windecker S, Kolh P, Alfonso F, et al. 2014 ESC/EACTS Guidelines on myocardial revascularization: the task force on myocardial revascularization of the European society of cardiology (ESC) and the European association for cardio-thoracic Surgery (EACTS) developed with the special contribution of the European association of percutaneous cardiovascular interventions (EAPCI). Eur Heart J. 2014;35(37):2541–619.PubMedCrossRef Windecker S, Kolh P, Alfonso F, et al. 2014 ESC/EACTS Guidelines on myocardial revascularization: the task force on myocardial revascularization of the European society of cardiology (ESC) and the European association for cardio-thoracic Surgery (EACTS) developed with the special contribution of the European association of percutaneous cardiovascular interventions (EAPCI). Eur Heart J. 2014;35(37):2541–619.PubMedCrossRef
36.
Zurück zum Zitat Daemen J, Wenaweser P, Tsuchida K, et al. Early and late coronary stent thrombosis of sirolimus-eluting and paclitaxel-eluting stents in routine clinical practice: data from a large two-institutional cohort study. Lancet. 2007;369(9562):667–78.PubMedCrossRef Daemen J, Wenaweser P, Tsuchida K, et al. Early and late coronary stent thrombosis of sirolimus-eluting and paclitaxel-eluting stents in routine clinical practice: data from a large two-institutional cohort study. Lancet. 2007;369(9562):667–78.PubMedCrossRef
37.
Zurück zum Zitat Mehta SR, Yusuf S, Peters RJ, et al. Effects of pretreatment with clopidogrel and aspirin followed by long-term therapy in patients undergoing percutaneous coronary intervention: the PCI-CURE study. Lancet. 2001;358(9281):527–33.PubMedCrossRef Mehta SR, Yusuf S, Peters RJ, et al. Effects of pretreatment with clopidogrel and aspirin followed by long-term therapy in patients undergoing percutaneous coronary intervention: the PCI-CURE study. Lancet. 2001;358(9281):527–33.PubMedCrossRef
38.
Zurück zum Zitat Steinhubl SR, Berger PB, Mann JT, et al. Early and sustained dual oral antiplatelet therapy following percutaneous coronary intervention: a randomized controlled trial. JAMA. 2002;288(19):2411–20.PubMedCrossRef Steinhubl SR, Berger PB, Mann JT, et al. Early and sustained dual oral antiplatelet therapy following percutaneous coronary intervention: a randomized controlled trial. JAMA. 2002;288(19):2411–20.PubMedCrossRef
39.
Zurück zum Zitat Colombo A, Chieffo A, Frasheri A, et al. Second-generation drug-eluting stent implantation followed by 6- versus 12-month dual antiplatelet therapy. The SECURITY randomized clinical trial. J Am Coll Cardiol. 2014;64(20):2086–97.PubMedCrossRef Colombo A, Chieffo A, Frasheri A, et al. Second-generation drug-eluting stent implantation followed by 6- versus 12-month dual antiplatelet therapy. The SECURITY randomized clinical trial. J Am Coll Cardiol. 2014;64(20):2086–97.PubMedCrossRef
40.
Zurück zum Zitat Feres F, Costa RA, Abizaid A, et al. Three vs twelve months of dual antiplatelet therapy after zotarolimus-eluting stents: the OPTIMIZE randomized trial. JAMA. 2013;310(23):2510–22.PubMed Feres F, Costa RA, Abizaid A, et al. Three vs twelve months of dual antiplatelet therapy after zotarolimus-eluting stents: the OPTIMIZE randomized trial. JAMA. 2013;310(23):2510–22.PubMed
41.
Zurück zum Zitat Faxon DP, Eikelboom JW, Berger PB, et al. Antithrombotic therapy in patients with atrial fibrillation undergoing coronary stenting: a North American perspective: executive summary. Circ Cardiovasc Interv. 2011;4(5):522–34.PubMedCrossRef Faxon DP, Eikelboom JW, Berger PB, et al. Antithrombotic therapy in patients with atrial fibrillation undergoing coronary stenting: a North American perspective: executive summary. Circ Cardiovasc Interv. 2011;4(5):522–34.PubMedCrossRef
42.••
Zurück zum Zitat Dewilde WJ, Oirbans T, Verheugt FW, et al. Use of clopidogrel with or without aspirin in patients taking oral anticoagulant therapy and undergoing percutaneous coronary intervention: an open-label, randomised, controlled trial. Lancet. 2013;381(9872):1107–15. This article provides the first evidence from a randomized controlled trial that OAC and clopidogrel are superior to TOAT over a 12-month period in Afib patients undergoing PCI.PubMedCrossRef Dewilde WJ, Oirbans T, Verheugt FW, et al. Use of clopidogrel with or without aspirin in patients taking oral anticoagulant therapy and undergoing percutaneous coronary intervention: an open-label, randomised, controlled trial. Lancet. 2013;381(9872):1107–15. This article provides the first evidence from a randomized controlled trial that OAC and clopidogrel are superior to TOAT over a 12-month period in Afib patients undergoing PCI.PubMedCrossRef
43.
Zurück zum Zitat Vardi M, Debidda M, Bhatt DL, et al. Evolving antithrombotic strategies in patients with atrial fibrillation undergoing percutaneous coronary intervention: results from a survey among US cardiologists. Clin Cardiol. 2014;37(2):103–7.PubMedCrossRef Vardi M, Debidda M, Bhatt DL, et al. Evolving antithrombotic strategies in patients with atrial fibrillation undergoing percutaneous coronary intervention: results from a survey among US cardiologists. Clin Cardiol. 2014;37(2):103–7.PubMedCrossRef
44.
Zurück zum Zitat Lamberts M, Olesen JB, Ruwald MH, et al. Bleeding after initiation of multiple antithrombotic drugs, including triple therapy, in atrial fibrillation patients following myocardial infarction and coronary intervention: a nationwide cohort study. Circulation. 2012;126(10):1185–93.PubMedCrossRef Lamberts M, Olesen JB, Ruwald MH, et al. Bleeding after initiation of multiple antithrombotic drugs, including triple therapy, in atrial fibrillation patients following myocardial infarction and coronary intervention: a nationwide cohort study. Circulation. 2012;126(10):1185–93.PubMedCrossRef
45.
Zurück zum Zitat Lamberts M, Gislason GH, Olesen JB, et al. Oral anticoagulation and antiplatelets in atrial fibrillation patients after myocardial infarction and coronary intervention. J Am Coll Cardiol. 2013;62(11):981–9.PubMedCrossRef Lamberts M, Gislason GH, Olesen JB, et al. Oral anticoagulation and antiplatelets in atrial fibrillation patients after myocardial infarction and coronary intervention. J Am Coll Cardiol. 2013;62(11):981–9.PubMedCrossRef
46.•
Zurück zum Zitat Lamberts M, Gislason GH, Lip GY, et al. Antiplatelet therapy for stable coronary artery disease in atrial fibrillation patients taking an oral anticoagulant: a nationwide cohort study. Circulation. 2014;129(15):1577–85. This large registry study shows that adding antiplatelet agents to VKA 12 months after PCI increases bleeding risk without reducing coronary or thromboembolic events.PubMedCrossRef Lamberts M, Gislason GH, Lip GY, et al. Antiplatelet therapy for stable coronary artery disease in atrial fibrillation patients taking an oral anticoagulant: a nationwide cohort study. Circulation. 2014;129(15):1577–85. This large registry study shows that adding antiplatelet agents to VKA 12 months after PCI increases bleeding risk without reducing coronary or thromboembolic events.PubMedCrossRef
47.
Zurück zum Zitat Kiviniemi T, Karjalainen P, Pietila M, et al. Comparison of additional versus no additional heparin during therapeutic oral anticoagulation in patients undergoing percutaneous coronary intervention. Am J Cardiol. 2012;110(1):30–5.PubMedCrossRef Kiviniemi T, Karjalainen P, Pietila M, et al. Comparison of additional versus no additional heparin during therapeutic oral anticoagulation in patients undergoing percutaneous coronary intervention. Am J Cardiol. 2012;110(1):30–5.PubMedCrossRef
48.••
Zurück zum Zitat Heidbuchel H, Verhamme P, Alings M, et al. European heart rhythm association practical guide on the use of new oral anticoagulants in patients with non-valvular atrial fibrillation. Europace. 2013;15(5):625–51. These guidelines address the selection of antiplatelet agents for patients requiring OAC for Afib in the setting of PCI.PubMedCrossRef Heidbuchel H, Verhamme P, Alings M, et al. European heart rhythm association practical guide on the use of new oral anticoagulants in patients with non-valvular atrial fibrillation. Europace. 2013;15(5):625–51. These guidelines address the selection of antiplatelet agents for patients requiring OAC for Afib in the setting of PCI.PubMedCrossRef
49.
Zurück zum Zitat Abraham NS, Hlatky MA, Antman EM, et al. 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 Am Coll Cardiol. 2010;56(24):2051–66.PubMedCrossRef Abraham NS, Hlatky MA, Antman EM, et al. 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 Am Coll Cardiol. 2010;56(24):2051–66.PubMedCrossRef
50.
Zurück zum Zitat Mearns ES, White CM, Kohn CG, et al. Quality of vitamin K antagonist control and outcomes in atrial fibrillation patients: a meta-analysis and meta-regression. Thromb J. 2014;12:14.PubMedCentralPubMedCrossRef Mearns ES, White CM, Kohn CG, et al. Quality of vitamin K antagonist control and outcomes in atrial fibrillation patients: a meta-analysis and meta-regression. Thromb J. 2014;12:14.PubMedCentralPubMedCrossRef
51.
Zurück zum Zitat Dangoisse V, Guedes A, Gabriel L, et al. Full conversion from transfemoral to transradial approach for percutaneous coronary interventions results in a similar success rate and a rapid reduction of in-hospital cardiac and vascular major events. EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology. EuroIntervention. 2013;9(3):345–52.PubMedCrossRef Dangoisse V, Guedes A, Gabriel L, et al. Full conversion from transfemoral to transradial approach for percutaneous coronary interventions results in a similar success rate and a rapid reduction of in-hospital cardiac and vascular major events. EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology. EuroIntervention. 2013;9(3):345–52.PubMedCrossRef
52.
Zurück zum Zitat Hamon M, Coutance G. Transradial intervention for minimizing bleeding complications in percutaneous coronary intervention. Am J Cardiol. 2009;104(5 Suppl):55C–9C.PubMedCrossRef Hamon M, Coutance G. Transradial intervention for minimizing bleeding complications in percutaneous coronary intervention. Am J Cardiol. 2009;104(5 Suppl):55C–9C.PubMedCrossRef
53.
Zurück zum Zitat Sciahbasi A, Pristipino C, Ambrosio G, et al. Arterial access-site-related outcomes of patients undergoing invasive coronary procedures for acute coronary syndromes (from the ComPaRison of early invasive and conservative treatment in patients with non-ST-ElevatiOn acute coronary syndromes [PRESTO-ACS] vascular Substudy). Am J Cardiol. 2009;103(6):796–800.PubMedCrossRef Sciahbasi A, Pristipino C, Ambrosio G, et al. Arterial access-site-related outcomes of patients undergoing invasive coronary procedures for acute coronary syndromes (from the ComPaRison of early invasive and conservative treatment in patients with non-ST-ElevatiOn acute coronary syndromes [PRESTO-ACS] vascular Substudy). Am J Cardiol. 2009;103(6):796–800.PubMedCrossRef
54.
Zurück zum Zitat Pancholy SB, Ahmed I, Bertrand OF, et al. Frequency of radial artery occlusion after transradial access in patients receiving warfarin therapy and undergoing coronary angiography. Am J Cardiol. 2014;113(2):211–4.PubMedCrossRef Pancholy SB, Ahmed I, Bertrand OF, et al. Frequency of radial artery occlusion after transradial access in patients receiving warfarin therapy and undergoing coronary angiography. Am J Cardiol. 2014;113(2):211–4.PubMedCrossRef
55.
Zurück zum Zitat Nairooz R, Sardar P, Amin H, et al. Meta-analysis of randomized clinical trials comparing bivalirudin versus heparin plus glycoprotein IIb/IIIa inhibitors in patients undergoing percutaneous coronary intervention and in patients with ST-segment elevation myocardial infarction. Am J Cardiol. 2014;114(2):250–9.PubMedCrossRef Nairooz R, Sardar P, Amin H, et al. Meta-analysis of randomized clinical trials comparing bivalirudin versus heparin plus glycoprotein IIb/IIIa inhibitors in patients undergoing percutaneous coronary intervention and in patients with ST-segment elevation myocardial infarction. Am J Cardiol. 2014;114(2):250–9.PubMedCrossRef
56.
Zurück zum Zitat Stone GW, Witzenbichler B, Guagliumi G, et al. Bivalirudin during primary PCI in acute myocardial infarction. N Engl J Med. 2008;358(21):2218–30.PubMedCrossRef Stone GW, Witzenbichler B, Guagliumi G, et al. Bivalirudin during primary PCI in acute myocardial infarction. N Engl J Med. 2008;358(21):2218–30.PubMedCrossRef
57.
Zurück zum Zitat Tonino PA, Fearon WF, De Bruyne B, et al. Angiographic versus functional severity of coronary artery stenoses in the FAME study fractional flow reserve versus angiography in multivessel evaluation. J Am Coll Cardiol. 2010;55(25):2816–21.PubMedCrossRef Tonino PA, Fearon WF, De Bruyne B, et al. Angiographic versus functional severity of coronary artery stenoses in the FAME study fractional flow reserve versus angiography in multivessel evaluation. J Am Coll Cardiol. 2010;55(25):2816–21.PubMedCrossRef
58.
Zurück zum Zitat Pijls NH, Fearon WF, Tonino PA, et al. Fractional flow reserve versus angiography for guiding percutaneous coronary intervention in patients with multivessel coronary artery disease: 2-year follow-up of the FAME (Fractional Flow Reserve Versus Angiography for Multivessel Evaluation) study. J Am Coll Cardiol. 2010;56(3):177–84.PubMedCrossRef Pijls NH, Fearon WF, Tonino PA, et al. Fractional flow reserve versus angiography for guiding percutaneous coronary intervention in patients with multivessel coronary artery disease: 2-year follow-up of the FAME (Fractional Flow Reserve Versus Angiography for Multivessel Evaluation) study. J Am Coll Cardiol. 2010;56(3):177–84.PubMedCrossRef
59.
Zurück zum Zitat Berger PB, Mahaffey KW, Meier SJ, et al. Safety and efficacy of only 2 weeks of ticlopidine therapy in patients at increased risk of coronary stent thrombosis: results from the antiplatelet therapy alone versus lovenox plus antiplatelet therapy in patients at increased risk of stent thrombosis (ATLAST) trial. Am Heart J. 2002;143(5):841–6.PubMedCrossRef Berger PB, Mahaffey KW, Meier SJ, et al. Safety and efficacy of only 2 weeks of ticlopidine therapy in patients at increased risk of coronary stent thrombosis: results from the antiplatelet therapy alone versus lovenox plus antiplatelet therapy in patients at increased risk of stent thrombosis (ATLAST) trial. Am Heart J. 2002;143(5):841–6.PubMedCrossRef
60.
Zurück zum Zitat Gilard M, Barragan P, Noryani AA, et al. Six-month versus 24-month dual antiplatelet therapy after implantation of drug eluting stents in patients non-resistant to aspirin: ITALIC, a randomized multicenter trial. J Am Coll Cardiol. 2014. doi:10.1016/j.jacc.2014.11.008.PubMed Gilard M, Barragan P, Noryani AA, et al. Six-month versus 24-month dual antiplatelet therapy after implantation of drug eluting stents in patients non-resistant to aspirin: ITALIC, a randomized multicenter trial. J Am Coll Cardiol. 2014. doi:10.​1016/​j.​jacc.​2014.​11.​008.PubMed
Metadaten
Titel
Antiplatelet Therapy During PCI for Patients with Stable Angina and Atrial Fibrillation
verfasst von
Amjid Iqbal
Fatima Rodriguez
Henrik Schirmer
Publikationsdatum
01.08.2015
Verlag
Springer US
Erschienen in
Current Cardiology Reports / Ausgabe 8/2015
Print ISSN: 1523-3782
Elektronische ISSN: 1534-3170
DOI
https://doi.org/10.1007/s11886-015-0615-7

Weitere Artikel der Ausgabe 8/2015

Current Cardiology Reports 8/2015 Zur Ausgabe

Invasive Electrophysiology and Pacing (EK Heist, Section Editor)

Pacing the Heart with Genes: Recent Progress in Biological Pacing

Nuclear Cardiology (V Dilsizian, Section Editor)

Prognostic Significance of Imaging Myocardial Sympathetic Innervation

Invasive Electrophysiology and Pacing (EK Heist, Section Editor)

Management of Ventricular Arrhythmias in Patients with Mechanical Ventricular Support Devices

Peripheral Vascular Disease (MR Jaff, Section Editor)

Nonatherosclerotic PAD: Approach to Exertional Pain in the Lower Extremities

Die „Zehn Gebote“ des Endokarditis-Managements

30.04.2024 Endokarditis Leitlinie kompakt

Worauf kommt es beim Management von Personen mit infektiöser Endokarditis an? Eine Kardiologin und ein Kardiologe fassen die zehn wichtigsten Punkte der neuen ESC-Leitlinie zusammen.

Strenge Blutdruckeinstellung lohnt auch im Alter noch

30.04.2024 Arterielle Hypertonie Nachrichten

Ältere Frauen, die von chronischen Erkrankungen weitgehend verschont sind, haben offenbar die besten Chancen, ihren 90. Geburtstag zu erleben, wenn ihr systolischer Blutdruck < 130 mmHg liegt. Das scheint selbst für 80-Jährige noch zu gelten.

Sind Frauen die fähigeren Ärzte?

30.04.2024 Gendermedizin Nachrichten

Patienten, die von Ärztinnen behandelt werden, dürfen offenbar auf bessere Therapieergebnisse hoffen als Patienten von Ärzten. Besonders gilt das offenbar für weibliche Kranke, wie eine Studie zeigt.

Dihydropyridin-Kalziumantagonisten können auf die Nieren gehen

30.04.2024 Hypertonie Nachrichten

Im Vergleich zu anderen Blutdrucksenkern sind Kalziumantagonisten vom Diyhdropyridin-Typ mit einem erhöhten Risiko für eine Mikroalbuminurie und in Abwesenheit eines RAS-Blockers auch für ein terminales Nierenversagen verbunden.

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.