Clinical Research in Cardiology

, Volume 109, Issue 1, pp 128–130 | Cite as

Antithrombotic therapy in atrial fibrillation: stop triple therapy and start optimizing dual therapy?

  • Bernhard Wernly
  • Michael Lichtenauer
  • David Erlinge
  • Christian JungEmail author
Letter to the Editors


Based on recent studies, we want to provoke thoughts on how to further optimize research on antiplatelet treatment in patients on oral anticoagulation (OAC).

One in three patients suffering from atrial fibrillation (AF) develops concomitant coronary artery disease. Hence, these patients are likely to undergo percutaneous coronary intervention (PCI). AF often leads to an indication for OAC, and after PCI, a dual antiplatelet therapy (DAPT) consisting of aspirin and a P2Y12 inhibitor is recommended. These overlapping recommendations led to many patients with AF after PCI and/or acute coronary syndrome (ACS) being on “triple therapy” (TT) consisting of OAC and DAPT. In TT, both non-vitamin-K-anticoagulants (NOACs) and vitamin-K-antagonists (VKA) are used. TT is thought to be effective in preventing thrombotic events, but known to be associated with risks of bleeding. This is of interest, as AF patients are often elderly and, therefore, at greater risk for bleeding complications....


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019
corrected publication 2019

Authors and Affiliations

  1. 1.Department of Cardiology, Clinic of Internal Medicine IIParacelsus Medical UniversitySalzburgAustria
  2. 2.Department of Cardiology, Clinical SciencesLund UniversityLundSweden
  3. 3.Division of Cardiology, Pulmonology, and Vascular Medicine, Medical FacultyUniversity of DüsseldorfDüsseldorfGermany

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