Long-Term Antithrombotic Therapy in Patients with Atrial Fibrillation and Percutaneous Coronary Intervention

Area of Science:

• Cardiology
• Pharmacology

Background:

• Atrial fibrillation (AF) patients undergoing percutaneous coronary intervention (PCI) require antithrombotic therapy.
• Current guidelines suggest a stepwise approach: initial triple therapy, followed by dual therapy, then anticoagulation monotherapy.
• Optimal long-term strategies remain controversial in clinical practice.

Purpose of the Study:

• To review evidence on chronic antithrombotic regimens for AF patients post-PCI.
• To focus on balancing ischemic and bleeding risks in treatment selection.
• To identify gaps in real-world implementation of evidence-based therapies.

Main Methods:

• Literature review of existing clinical evidence.
• Analysis of antithrombotic regimens including oral anticoagulation monotherapy and dual therapy.
• Evaluation of safety and efficacy data.

Main Results:

• Growing evidence supports the safety and efficacy of oral anticoagulation monotherapy.
• Clinical practice shows inconsistent adoption of recommended long-term strategies.
• A significant gap exists between robust evidence and real-world application.

Conclusions:

• Oral anticoagulation monotherapy is a viable option for long-term antithrombotic treatment in select AF patients post-PCI.
• Further efforts are needed to bridge the gap between evidence and clinical practice for optimal patient outcomes.
• Personalized selection of antithrombotic regimens is crucial to balance efficacy and safety.