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05:26
Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
Published on: May 28, 2019
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Is There a Role for Triple Therapy After ACS?
Sukhdeep Bhogal1, Mohamad Alkhouli2, Christopher J White3
1Medstar Washington Hospital Center, Washington, DC, USA.
Current Cardiology Reports
|February 3, 2022
Summary
For atrial fibrillation patients undergoing percutaneous coronary intervention, dual therapy with a non-vitamin K oral anticoagulant and clopidogrel is preferred over triple therapy. This approach reduces bleeding without increasing thrombotic events.
Area of Science:
- Cardiology
- Pharmacology
- Thrombosis Research
Background:
- Atrial fibrillation (AF) patients undergoing percutaneous coronary intervention (PCI) require careful antithrombotic management.
- The optimal strategy balancing efficacy and safety is debated, particularly regarding triple therapy.
Purpose of the Study:
- To review current evidence on antithrombotic strategies for AF patients post-PCI.
- To evaluate the role of triple therapy versus alternative regimens in acute coronary syndrome (ACS) patients.
Main Methods:
- Review of recently published clinical trials comparing different antithrombotic regimens.
- Analysis of outcomes related to bleeding complications and thromboembolic events.
Main Results:
- Combination of non-vitamin K oral anticoagulants (NOACs) with antiplatelet agents showed non-inferiority or superiority in reducing bleeding compared to vitamin K antagonist (VKA) plus dual antiplatelet therapy (DAPT).
- No significant difference in thromboembolic events was observed between the NOAC-based dual therapy and VKA-based triple therapy.
- Dual therapy, preferably with a NOAC and clopidogrel, is now recommended over triple therapy.
Conclusions:
- Dual therapy with NOACs and clopidogrel is favored for AF patients undergoing PCI.
- Optimal duration of dual therapy should be individualized based on thrombosis and bleeding risk assessment.
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