Related Experiment Video

Updated: Dec 3, 2025

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
28:13

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

Published on: February 26, 2013

33.7K

Dual-Pathway Antithrombotic Therapy in Patients With Atrial Fibrillation After Percutaneous Coronary Intervention in

Lukas Andreas Heger1, Martin Danzer1, Christoph Bode1

  • 1Department of Cardiology and Angiology I, Heart Center Freiburg University, Faculty of Medicine, University of Freiburg, Freiburg, Germany.

Frontiers in Medicine
|October 29, 2020
PubMed

Insights

Antithrombotic therapy for atrial fibrillation patients after PCI is shifting. Prescriptions for triple antithrombotic therapy and vitamin K antagonists decreased, favoring dual therapy with non-vitamin K antagonist oral anticoagulants.

Area of Science:

  • Cardiology
  • Pharmacology
  • Clinical Practice

Background:

  • Limited data exists on antithrombotic therapy prescription for atrial fibrillation (AF) patients post-elective percutaneous coronary intervention (PCI).
  • Understanding current prescription trends is crucial for optimizing patient care and reducing adverse events.

Purpose of the Study:

  • To evaluate trends in antithrombotic treatment strategies for patients with AF undergoing elective PCI.
  • To compare the use of vitamin K antagonists (VKA) versus non-vitamin K antagonist oral anticoagulants (NOAC) in this patient population.

Main Methods:

  • Retrospective cohort study of 259 AF patients who underwent elective PCI between April 2013 and May 2018.
  • Antithrombotic therapy at discharge was assessed, categorizing treatments as triple antithrombotic therapy (TAT) or dual antithrombotic therapy (DAT).
  • Comparison of VKA and NOAC use, including bleeding risk assessment (HAS-BLED score) and comorbidities.

Main Results:

  • 51% of patients received NOACs, while 49% received VKAs.
  • VKA-treated patients had higher bleeding risk and more comorbidities compared to NOAC-treated patients.
  • Triple antithrombotic therapy (TAT) was more frequent with VKA than NOAC (61% vs. 41%).
  • Prescription of TAT and VKA significantly decreased from 2013 to 2018 (TAT: 100% to 6%; VKA: 91% to 28%).

Conclusions:

  • Observational data indicate a shift towards dual antithrombotic therapy (DAT) with NOACs, away from TAT and VKAs.
  • This trend suggests evolving clinical practice in managing AF patients post-PCI.
  • Further studies are needed to confirm if these findings align with national and global trends.

Keywords:
antithrombotic therapyatrial fibrillationoral anticoagulationpercutaneous coronary interventionsingle centersingle operator retrospective analysistriple therapy

More Related Videos

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation23:33

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation

Published on: February 28, 2012

84.2K
Non-fluoroscopic Catheter Tracking for Fluoroscopy Reduction in Interventional Electrophysiology10:46

Non-fluoroscopic Catheter Tracking for Fluoroscopy Reduction in Interventional Electrophysiology

Published on: May 26, 2015

13.6K

Related Concept Videos

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...
145
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...
125
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...
146
Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
114
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...
158
Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations

The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
235