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Balancing Antiplatelet and Anticoagulant Therapies in Patients with Cardiovascular Disease

Balancing Antiplatelet and Anticoagulant Therapies in Patients with Cardiovascular Disease Anticoagulation is needed for stroke prevention in patients with atrial fibrillation. Antiplatelet therapy is essential for the prevention of stent thrombosis and the reduction of cardiovascular events in patients who undergo coronary stenting and suffer acute coronary syndromes. When these conditions overlap, the individual antithrombotic strategies are commonly combined, and the efficacy benefit of triple oral antithrombotic therapy is assumed to outweigh the bleeding risk based on the available data. Recent studies have investigated this topic further, including the first randomized controlled trial to address this issue. This new evidence challenges previous assumptions and may have implications for future practice and investigation. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Cardiology and Therapy Springer Journals

Balancing Antiplatelet and Anticoagulant Therapies in Patients with Cardiovascular Disease

Carreras, Edward; Mega, Jessica
Cardiology and Therapy , Volume 2 (1) – Apr 25, 2013
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12 pages

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Publisher
Springer Journals
Copyright
Copyright © 2013 by The Author(s)
Subject
Medicine & Public Health; Internal Medicine; Cardiology
ISSN
2193-8261
eISSN
2193-6544
DOI
10.1007/s40119-013-0015-2
pmid
25135291
Publisher site
See Article on Publisher Site

Abstract

Anticoagulation is needed for stroke prevention in patients with atrial fibrillation. Antiplatelet therapy is essential for the prevention of stent thrombosis and the reduction of cardiovascular events in patients who undergo coronary stenting and suffer acute coronary syndromes. When these conditions overlap, the individual antithrombotic strategies are commonly combined, and the efficacy benefit of triple oral antithrombotic therapy is assumed to outweigh the bleeding risk based on the available data. Recent studies have investigated this topic further, including the first randomized controlled trial to address this issue. This new evidence challenges previous assumptions and may have implications for future practice and investigation.

Journal

Cardiology and Therapy – Springer Journals

Published: Apr 25, 2013

References

  • Heart disease and stroke statistics—2013 update a report from the American Heart Association
    Go, AS; Mozaffarian, D; Roger, VL
  • Antithrombotic therapy in patients with atrial fibrillation undergoing coronary stenting: a North American perspective: executive summary
    Faxon, DP; Eikelboom, JW; Berger, PB
  • Antithrombotic therapy for atrial fibrillation: antithrombotic therapy and prevention of thrombosis, 9th edn. American College of Chest Physicians evidence-based clinical practice guidelines
    You, JJ; Singer, DE; Howard, PA
  • Validation of clinical classification schemes for predicting stroke: results from the national registry of atrial fibrillation
    Gage, BF; Waterman, AD; Shannon, W; Boechler, M; Rich, MW; Radford, MJ
  • 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
    Connolly, S; Pogue, J; Hart, R
  • Meta-analysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation
    Hart, RG; Pearce, LA; Aguilar, MI
  • Lifetime risk for development of atrial fibrillation: the framingham heart study
    Lloyd-Jones, DM; Wang, TJ; Leip, EP
  • Collaborative overview of randomised trials of antiplatelet therapy–I: prevention of death, myocardial infarction, and stroke by prolonged antiplatelet therapy in various categories of patients
  • Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes without st-segment elevation
    Yusuf, S; Zhao, F; Mehta, SR; Chrolavicius, S; Tognoni, G; Fox, KK
  • A clinical trial comparing three antithrombotic-drug regimens after coronary-artery stenting. Stent anticoagulation restenosis study investigators
    Leon, MB; Baim, DS; Popma, JJ
  • Ticagrelor versus clopidogrel in patients with acute coronary syndromes
    Wallentin, L; Becker, RC; Budaj, A
  • Prasugrel versus clopidogrel in patients with acute coronary syndromes
    Wiviott, SD; Braunwald, E; McCabe, CH
  • Duration of dual antiplatelet therapy after implantation of drug-eluting stents
    Park, SJ; Park, DW; Kim, YH
  • Randomized comparison of 6- versus 24-month clopidogrel therapy after balancing anti-intimal hyperplasia stent potency in all-comer patients undergoing percutaneous coronary intervention design and rationale for the prolonging dual-antiplatelet treatment after grading stent-induced intimal hyperplasia study (prodigy)
    Valgimigli, M; Campo, G; Percoco, G
  • Rationale and design of a randomized, double-blind, placebo-controlled trial of 6 versus 12 months clopidogrel therapy after implantation of a drug-eluting stent: the intracoronary stenting and antithrombotic regimen: safety and efficacy of 6 months dual antiplatelet therapy after drug-eluting stenting (ISAR-SAFE) study
    Byrne, RA; Schulz, S; Mehilli, J
  • Duration of dual antiplatelet therapy after percutaneous coronary intervention with drug-eluting stent implantation: a review of the current guidelines and literature
    Lemesle, G; Paparoni, F; Delhaye, C; Bonello, L; Lablanche, JM
  • Warfarin plus aspirin after myocardial infarction or the acute coronary syndrome: meta-analysis with estimates of risk and benefit
    Rothberg, MB; Celestin, C; Fiore, LD; Lawler, E; Cook, JR
  • Aspirin plus warfarin compared to aspirin alone after acute coronary syndromes: an updated and comprehensive meta-analysis of 25,307 patients
    Andreotti, F; Testa, L; Biondi-Zoccai, GG; Crea, F
  • Warfarin, aspirin, or both after myocardial infarction
    Hurlen, M; Abdelnoor, M; Smith, P; Erikssen, J; Arnesen, H
  • Aspirin and coumadin after acute coronary syndromes (the aspect-2 study): a randomised controlled trial
    Es, RF; Jonker, JJ; Verheugt, FW; Deckers, JW; Grobbee, DE
  • Anticoagulant and antiplatelet therapy use in 426 patients with atrial fibrillation undergoing percutaneous coronary intervention and stent implantation implications for bleeding risk and prognosis
    Ruiz-Nodar, JM; Marin, F; Hurtado, JA
  • Combination therapy with aspirin, clopidogrel and warfarin following coronary stenting is associated with a significant risk of bleeding
    Khurram, Z; Chou, E; Minutello, R
  • Risk of major bleeding with concomitant dual antiplatelet therapy after percutaneous coronary intervention in patients receiving long-term warfarin therapy
    DeEugenio, D; Kolman, L; DeCaro, M
  • Safety and efficacy of combined antiplatelet-warfarin therapy after coronary stenting
    Karjalainen, PP; Porela, P; Ylitalo, A
  • Aspirin and clopidogrel with or without phenprocoumon after drug eluting coronary stent placement in patients on chronic oral anticoagulation
    Sarafoff, N; Ndrepepa, G; Mehilli, J
  • Long-term outcomes in patients undergoing coronary stenting on dual oral antiplatelet treatment requiring oral anticoagulant therapy
    Rossini, R; Musumeci, G; Lettieri, C
  • Combining antiplatelet and anticoagulant therapies
    Holmes, DR; Kereiakes, DJ; Kleiman, NS; Moliterno, DJ; Patti, G; Grines, CL
  • Antithrombotic management of atrial fibrillation patients presenting with acute coronary syndrome and/or undergoing coronary stenting: executive summary—a consensus document of the european society of cardiology working group on thrombosis, endorsed by the european heart rhythm association (ehra) and the european association of percutaneous cardiovascular interventions (eapci)
    Lip, GY; Huber, K; Andreotti, F
  • Bleeding after initiation of multiple antithrombotic drugs, including triple therapy, in atrial fibrillation patients following myocardial infarction and coronary intervention: a nationwide cohort study
    Lamberts, M; Olesen, JB; Ruwald, MH
  • Design and rationale of the WOEST trial: What is the optimal antiplatelet and anticoagulant therapy in patients with oral anticoagulation and coronary stenting (WOEST)
    Dewilde, W; Berg, JT
  • Use of clopidogrel with or without aspirin in patients taking oral anticoagulant therapy and undergoing percutaneous coronary intervention: an open-label, randomised, controlled trial
    Dewilde, WJ; Oirbans, T; Verheugt, FW
  • Rivaroxaban versus warfarin in nonvalvular atrial fibrillation
    Patel, MR; Mahaffey, KW; Garg, J
  • Dabigatran versus warfarin in patients with atrial fibrillation
    Connolly, SJ; Ezekowitz, MD; Yusuf, S
  • Apixaban versus warfarin in patients with atrial fibrillation
    Granger, CB; Alexander, JH; McMurray, JJ
  • 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
    Alexander, JH; Becker, RC; Bhatt, DL
  • Apixaban with antiplatelet therapy after acute coronary syndrome
    Alexander, JH; Lopes, RD; James, S
  • Rivaroxaban versus placebo in patients with acute coronary syndromes (ATLAS ACS-TIMI 46): a randomised, double-blind, phase ii trial
    Mega, JL; Braunwald, E; Mohanavelu, S
  • Rivaroxaban in patients with a recent acute coronary syndrome
    Mega, JL; Braunwald, E; Wiviott, SD