Optimizing Antithrombotic Therapy After Coronary Stent Implantation in Patients on Chronic Oral Anticoagulation

  • N. Bennaghmouch
  • D. Sprenkeler
  • K. Qaderdan
  • J. M. ten Berg
Article

DOI: 10.1007/s12265-013-9536-2

Cite this article as:
Bennaghmouch, N., Sprenkeler, D., Qaderdan, K. et al. J. of Cardiovasc. Trans. Res. (2014) 7: 64. doi:10.1007/s12265-013-9536-2

Abstract

Most patients on chronic oral anticoagulation have a lifelong indication. When these patients undergo percutaneous coronary interventions with stent implantation, they also have an indication for dual antiplatelet therapy (aspirin and a P2Y12 inhibitor). However, this so-called triple therapy results in increased bleeding risks which in turn is associated with increased mortality. Furthermore, emerging stronger antiplatelet drugs (prasugrel and ticagrelor) are associated with increased bleeding, making triple therapy even more hazardous. This created a clinical treatment dilemma for this subset of patients, and new trials have been designed to explore new treatment strategies. This review summarizes the available evidence regarding the optimal treatment of patients on chronic oral anticoagulation undergoing percutaneous coronary interventions with stent implantation.

Keywords

Percutaneous coronary interventionAtrial fibrillationTriple therapyOral anticoagulationDual antiplatelet therapyClopidogrel

Supplementary material

12265_2013_9536_MOESM1_ESM.pdf (42 kb)
ESM 1(PDF 41 kb)
12265_2013_9536_MOESM2_ESM.doc (35 kb)
ESM 2(DOC 35 kb)

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • N. Bennaghmouch
    • 1
  • D. Sprenkeler
    • 1
  • K. Qaderdan
    • 1
  • J. M. ten Berg
    • 1
  1. 1.Department of CardiologySt. Antonius Hospital NieuwegeinNieuwegeinThe Netherlands