AI Article Synopsis
- The review highlights the challenges of managing antithrombotic therapy for atrial fibrillation (AF) patients undergoing percutaneous coronary intervention (PCI), emphasizing the need to balance the prevention of ischemic events and minimizing bleeding risks.
- It spans research from 2010 to October 2023 and calls for personalized treatment strategies to optimize antithrombotic therapy in these patients.
- The expert opinion favors double antithrombotic therapy (DAT) over triple therapy (TAT) for better safety without compromising effectiveness, recommending NOAC-based DAT post-PCI while addressing ongoing challenges in specific patient groups.
Article Abstract
Introduction: Balancing antithrombotic therapy for atrial fibrillation (AF) patients undergoing percutaneous coronary intervention (PCI) remains a clinical challenge due to coexisting thrombogenic risks. This review emphasizes the delicate balance required to prevent ischemic events while minimizing bleeding complications, particularly in the context of risk assessment.
Areas Covered: This review spans from 2010 to October 2023, exploring the complexities of antithrombotic management for AF patients undergoing PCI. It stresses the need for personalized treatment decisions to optimize antithrombotic therapies effectively.
Expert Opinion: The evolving evidence supports double antithrombotic therapy (DAT) over triple antithrombotic therapy (TAT) for these patients, showcasing a more favorable safety profile without compromising efficacy. Non-vitamin K antagonist oral anticoagulant (NOAC)-based DAT strategies exhibit superiority in reducing major bleeding events while effectively preventing ischemic events. Recommendations from the 2023 European Society of Cardiology (ESC) Guidelines advocate for NOAC-based DAT post-PCI, endorsing safer antithrombotic profiles.Challenges persist for specific patient categories requiring both oral anticoagulants and antiplatelets, necessitating personalized approaches. Future advances in intravascular imaging and novel coronary stent technologies offer promising avenues to optimize outcomes and influence antithrombotic strategies in AF-PCI patients.
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| http://dx.doi.org/10.1080/14740338.2024.2305367 | DOI Listing |
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