Related Experiment Video

Updated: Dec 23, 2025

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
23:33

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation

Published on: February 28, 2012

84.3K

Antithrombotic Therapy for Patients With Atrial Fibrillation and Acute Coronary Syndrome or Percutaneous Coronary

Andrew S Tseng, Fadi E Shamoun, Lisa A Marks

    The Journal of the American Osteopathic Association
    |April 28, 2020
    PubMed

    Insights

    For atrial fibrillation patients with acute coronary syndrome or undergoing PCI, double therapy with direct oral anticoagulants and clopidogrel is effective and safer than warfarin. This combination is recommended, with triple therapy considered for high-risk cases.

    Area of Science:

    • Cardiology
    • Pharmacology
    • Clinical Medicine

    Background:

    • Atrial fibrillation (AF) patients often require antithrombotic therapy.
    • Managing AF patients with acute coronary syndrome (ACS) or undergoing percutaneous coronary intervention (PCI) presents a complex therapeutic challenge.
    • Balancing the risk of thrombotic events with bleeding complications is crucial.

    Purpose of the Study:

    • To review current guidelines on combination antithrombotic therapy for AF patients with ACS or undergoing PCI.
    • To compare the efficacy and safety of different antithrombotic regimens.

    Main Methods:

    • Evidence synthesis based on latest ACC, AHA, ESC, and HRS guidelines.
    • Comparison of double therapy (DT) with direct oral anticoagulants (DOACs) plus clopidogrel versus warfarin-based therapies and triple therapy (TT).

    Main Results:

    • Double therapy (DT) with DOACs (dabigatran, rivaroxaban, apixaban) plus clopidogrel is noninferior to warfarin-based therapies for most AF patients.
    • DT demonstrates noninferiority to triple therapy (TT) with significantly fewer bleeding complications.
    • TT may be beneficial for 1–6 months in patients undergoing PCI or with high ischemic risk before switching to DT.

    Conclusions:

    • DT with DOACs and clopidogrel is an acceptable antithrombotic strategy for AF patients undergoing PCI, aligning with current guidelines.
    • Individualized treatment duration for antiplatelet therapy (DT or TT) is essential, guided by DAPT protocols and cardiologist consultation.
    • Further guidance on long-term antiplatelet therapy in this patient population is needed.

    More Related Videos

    Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation28:13

    Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

    Published on: February 26, 2013

    33.8K
    Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function10:28

    Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function

    Published on: March 15, 2022

    5.7K

    Related Concept Videos

    Acute Coronary Syndrome IV: Interprofessional Care01:28

    Acute Coronary Syndrome IV: Interprofessional Care

    IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
    166
    Venous Thrombosis III: Interprofessional Care01:29

    Venous Thrombosis III: Interprofessional Care

    Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
    213
    Coronary Artery Disease V: Interprofessional Care01:27

    Coronary Artery Disease V: Interprofessional Care

    Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
    179
    Anticoagulant Drugs: Low-Molecular-Weight Heparins01:30

    Anticoagulant Drugs: Low-Molecular-Weight Heparins

    Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
    1.4K
    Acute Coronary Syndrome I: Introduction01:30

    Acute Coronary Syndrome I: Introduction

    Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
    578
    Peripheral Artery Disease III: Interprofessional Care01:27

    Peripheral Artery Disease III: Interprofessional Care

    Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
    178