Document Detail


Atrial fibrillation and percutaneous coronary intervention: stroke, thrombosis, and bleeding.
MedLine Citation:
PMID:  21340701     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
Currently available data suggest that patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI) with stenting who do not continue oral anticoagulation are at increased risk for mortality and morbidity. In this patient population, therapy directed at reducing both thromboembolism (via oral anticoagulation) and stent thrombosis (via dual antiplatelet therapy) is necessary but is associated with an increased risk for bleeding. For patients with a high risk for thromboembolism based on published AF risk scores, the use of bare metal stents is recommended to minimize the duration of triple therapy. During the time period when triple therapy is used, the International Normalized Ratio (INR) should be maintained at the lower end of therapeutic range (2.0), and lower dose aspirin should be used. Finally, as newer oral anticoagulation agents such as dabigatran and rivaroxaban become available, further research will be required to determine their safety and efficacy in patients with AF undergoing PCI with stenting.
Authors:
Antonio Gutierrez; Sunil V Rao
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Current treatment options in cardiovascular medicine     Volume:  13     ISSN:  1534-3189     ISO Abbreviation:  Curr Treat Options Cardiovasc Med     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-05-03     Completed Date:  2011-07-14     Revised Date:  2013-07-25    
Medline Journal Info:
Nlm Unique ID:  9815942     Medline TA:  Curr Treat Options Cardiovasc Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  203-14     Citation Subset:  -    
Affiliation:
Department of Medicine, Duke University School of Medicine, DUMC 3850, Durham, NC, 27710, USA, antonio.gutierrez@duke.edu.
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