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Aspirin, warfarin and a thienopyridine for acute coronary syndromes

Yuval Konstantino1, Zaza Iakobishvili, Avital Porter

  • 1Department of Cardiology, Rabin Medical Center, Petah-Tikva, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Cardiology
|November 16, 2005
PubMed

Insights

Triple therapy (TT) using warfarin alongside dual therapy (DT) in acute coronary syndrome (ACS) patients is feasible. While TT patients experienced more bleeding events, adjusted mortality rates at 30 days and 6 months were similar between groups.

Area of Science:

  • Cardiology
  • Pharmacology
  • Clinical Research

Background:

  • Dual therapy (DT) with clopidogrel and aspirin is standard for acute coronary syndrome (ACS).
  • Triple therapy (TT), involving warfarin in addition to DT, is sometimes necessary for specific ACS patient populations.

Purpose of the Study:

  • To investigate the incidence, complications, and outcomes associated with triple therapy (TT) in ACS patients.
  • To compare the safety and efficacy of TT versus DT in the management of ACS.

Main Methods:

  • Analysis of Israeli national surveys data for ACS patients from 2000 to 2004.
  • Comparison of patient demographics, treatment protocols, and clinical outcomes between TT and DT groups.

Main Results:

  • Triple therapy (TT) was administered to 1.3% of ACS patients (n=76), who were older and had more prior cardiac disease.
  • TT patients experienced higher rates of heart failure, arrhythmias, ischemia, and major bleeding (2.6% vs. 0.6%, p=0.03) during hospitalization.
  • No significant differences in adjusted 30-day and 6-month mortality were observed between the TT and DT groups.

Conclusions:

  • Triple therapy (TT) is a feasible treatment option for ACS patients requiring concurrent warfarin therapy.
  • Careful monitoring for complications, particularly bleeding, is essential in ACS patients undergoing TT.
Abstract

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