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The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
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Published on: February 28, 2012

Atrial fibrillation and percutaneous coronary intervention: stroke, thrombosis, and bleeding

Antonio Gutierrez1, Sunil V Rao

  • 1Department of Medicine, Duke University School of Medicine, DUMC 3850, Durham, NC, 27710, USA, antonio.gutierrez@duke.edu.

Current Treatment Options in Cardiovascular Medicine
|February 23, 2011
PubMed

Insights

Patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI) need oral anticoagulation to prevent mortality and morbidity. Balancing anticoagulation and antiplatelet therapy is crucial to minimize bleeding risk in these high-risk patients.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI) face increased risks of mortality and morbidity without continued oral anticoagulation.
  • The necessary combination of oral anticoagulation and dual antiplatelet therapy increases bleeding risk.

Purpose of the Study:

  • To outline management strategies for patients with AF undergoing PCI.
  • To address the balance between preventing thromboembolism and minimizing bleeding complications.

Main Methods:

  • Review of current data and clinical recommendations for AF patients undergoing PCI.
  • Emphasis on risk stratification using AF risk scores.

Main Results:

  • Bare metal stents are recommended for high-risk AF patients to shorten triple therapy duration.
  • Maintaining International Normalized Ratio (INR) at the lower end of the therapeutic range (2.0) and using lower-dose aspirin during triple therapy are advised.

Conclusions:

  • Careful management of anticoagulation and antiplatelet therapy is essential for AF patients undergoing PCI.
  • Further research is needed on newer oral anticoagulants (e.g., dabigatran, rivaroxaban) in this patient population.
Abstract

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