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The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
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Antithrombotic therapy in patients with atrial fibrillation undergoing coronary stenting: a North American

David P Faxon1, John W Eikelboom, Peter B Berger

  • 1Brigham and Women’s Hospital, 1620 Tremont St, Boston, MA 02120, USA. dfaxon@partners.org

Circulation. Cardiovascular Interventions
|October 20, 2011
PubMed

Insights

For patients with atrial fibrillation and coronary stents, optimal antithrombotic therapy balancing stroke, stent thrombosis, and bleeding risks remains unclear. This summary offers guidance on managing these complex treatment decisions.

Area of Science:

  • Cardiology
  • Pharmacology
  • Clinical Medicine

Background:

  • Optimal antithrombotic therapy for patients with atrial fibrillation and coronary stents is not well-defined.
  • Triple therapy (aspirin, clopidogrel, warfarin) increases bleeding risk.
  • National guidelines lack specific recommendations due to insufficient data.

Discussion:

  • Balancing risks of stroke, stent thrombosis, and major bleeding is crucial.
  • Considerations include vascular access, stent choice, and proton pump inhibitor use.
  • Recommendations focus on the duration and use of triple therapy post-stent placement.

Key Insights:

  • Current data is insufficient for definitive national guidelines on antithrombotic therapy in this patient group.
  • Risk assessment is paramount in selecting appropriate antithrombotic strategies.
  • Specific recommendations are provided for managing triple therapy after coronary stent placement.

Outlook:

  • Further research is needed to establish optimal antithrombotic regimens.
  • Individualized treatment plans based on patient risk factors are essential.
  • Future guidelines will likely incorporate more precise recommendations for this complex patient population.

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