Review of modern concepts of triple and double antiplatelettherapy in patients with atrial fibrillationand coronary artery disease

Authors: Ruzina E.V., Golukhova E.Z.

Company: Bakoulev National Medical Research Center for Cardiovascular Surgery, Ministry of Health of the Russian Federation, Rublevskoe shosse, 135, Moscow, 121552, Russian Federation

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Type:  Reviews


DOI: https://doi.org/10.24022/1997-3187-2019-13-4-308-319

For citation: Ruzina E.V., Golukhova E.Z. Review of modern concepts of triple and double antiplatelet therapy in patients with atrial fibrillation and coronary artery disease. Creative Cardiology. 2019; 13 (4): 308–19 (in Russ.). DOI: 10.24022/1997-3187-2019-13-4-308-319

Received / Accepted:  02.12.2019/10.12.2019

Keywords: atrial fibrillation coronary heart disease vitamin K antagonists new oral anticoagulants antiplatelet therapy

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Abstract

Atrial fibrillation (AF) is the most common heart rhythm disorder in the general population. 5–10% of patients undergoing percutaneous coronary intervention (PCI) for coronary artery disease have concomitant AF, and, as a result, the need for oral anticoagulants (OAC) in addition to antiplatelet therapy. Over the past few years, with atrial fibrillation, as a well-known anticoagulant – a vitamin K antagonist (warfarin), new OAC (rivaroxaban, dabigatran, apixaban) has been increasingly used, which have successfully passed all clinical trials, are convenient in use and not only require INR control, but also any other indicators of the coagulogram. However, the use of new OAC in conjunction with antiplatelet drugs raises many questions and concerns about an increase in the frequency of hemorrhagic complications. The article provides an overview of modern studies from 2012 to the present, aimed at studying various combinations and the duration of taking antiplatelet and anticoagulant drugs. To date, the appointment of double and triple antithrombotic therapy in patients after acute coronary syndrome / PCI and AF continues to remain open, given the high risks of relapse of embolic events and, especially, bleeding.

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About Authors

  • Evgeniya V. Ruzina, Postgraduate, Cardiologist, ORCID
  • Elena Z. Golukhova, Dr. Med. Sc., Professor, Academician of Russian Academy of Sciences, Head of Department, Acting Director, ORCID

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, Director of Bakoulev National Medical Research Center for Cardiovascular Surgery