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[Antithrombotic Therapy in Atrial Fibrillation and Chronic Ischemic Heart Disease]

A Yu Rychkov1, N Yu Khorkova1

  • 1Tyumen Cardiology Research Center; Tomsk National Research Medical Center, Russian Academy of Science.

Kardiologiia
|May 28, 2019
PubMed

Insights

This review explores antithrombotic therapy for atrial fibrillation and ischemic heart disease patients. Oral anticoagulants show benefits for secondary prevention and in combination therapy, with dual therapy effective post-PCI.

Area of Science:

  • Cardiology
  • Pharmacology
  • Internal Medicine

Background:

  • Atrial fibrillation (AF) and chronic ischemic heart disease (IHD) frequently coexist.
  • Optimal antithrombotic management in these patients is complex.
  • Secondary prevention of IHD and management of AF require careful consideration of therapeutic options.

Purpose of the Study:

  • To review current evidence on antithrombotic therapy in patients with both AF and IHD.
  • To assess the role of oral anticoagulants (OACs) in secondary prevention of IHD.
  • To evaluate the efficacy and safety of OAC monotherapy and dual antithrombotic therapy.

Main Methods:

  • Review of international registries and meta-analyses.
  • Analysis of randomized and observational clinical studies.
  • Evaluation of data on direct oral anticoagulants (DOACs) and percutaneous coronary intervention (PCI).

Main Results:

  • International data support the use of OACs for secondary IHD prevention.
  • Clinical studies demonstrate advantages of OAC monotherapy in patients with AF and IHD.
  • Evidence supports dual antithrombotic therapy with DOACs after PCI.

Conclusions:

  • Antithrombotic therapy, particularly with OACs, plays a crucial role in managing patients with concurrent AF and IHD.
  • OAC monotherapy offers benefits for secondary IHD prevention in this population.
  • Dual antithrombotic therapy with DOACs is a valuable strategy post-PCI.

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