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The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
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Consensus document: antithrombotic therapy in patients with atrial fibrillation undergoing coronary stenting. A

David P Faxon1, John W Eikelboom, Peter B Berger

  • 1Division of Cardiology, Brigham and Women's Hospital, 1620 Tremont Street, OBC-3-12J, Boston, MA 02120, USA. dfaxon@partners.org

Thrombosis and Haemostasis
|July 26, 2011
PubMed

Insights

Optimal anticoagulant and antiplatelet therapy after coronary stent placement in atrial fibrillation patients remains unclear. This guide assesses risks of stroke, stent thrombosis, and bleeding to recommend best antithrombotic strategies.

Area of Science:

  • Cardiology
  • Pharmacology
  • Thrombosis Research

Background:

  • Optimal antithrombotic therapy for atrial fibrillation (AF) patients with coronary stents is undefined.
  • Triple therapy (aspirin, clopidogrel, warfarin) increases bleeding risk.
  • Lack of data limits national guideline recommendations.

Framework:

  • Risk assessment balancing stroke, stent thrombosis, and major bleeding.
  • Consideration of vascular access, stent choice, and proton-pump inhibitor use.
  • Guidelines for the duration and use of triple therapy post-stent placement.

Implementation:

  • Develop evidence-based recommendations for antithrombotic regimens.
  • Integrate risk stratification into clinical decision-making.
  • Educate clinicians on managing complex antithrombotic needs.

Implications:

  • Improved patient outcomes through tailored antithrombotic strategies.
  • Reduced incidence of bleeding and thrombotic events.
  • Foundation for future clinical trials and guideline development.

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