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‘Ins’ and ‘outs’ of triple therapy

Optimal antiplatelet therapy in patients on chronic oral anticoagulation who need coronary stenting

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Abstract

Chronic oral anticoagulant treatment is obligatory in patients (class I) with mechanical heart valves and in patients with atrial fibrillation with CHADS2 score >1. When these patients undergo percutaneous coronary intervention with placement of a stent, there is also an indication for treatment with aspirin and clopidogrel. Unfortunately, triple therapy is known to increase the bleeding risk. For this group of patients, the bottom line is to find the ideal therapy in patients with indications for both chronic anticoagulation therapy and percutaneous intervention to prevent thromboembolic complications such as stent thrombosis without increasing the risk of bleeding. (Neth Heart J 2010;18:444-50.)

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Correspondence to W. Dewilde.

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TweeSteden Hospital, Tilburg, the Netherlands

Department of Cardiology, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands

St Antonius Hospital, Nieuwegein, the Netherlands

Catharina Hospital, Eindhoven, the Netherlands

W. Dewilde TweeSteden Hospital Tilburg, PO Box 0107, 5000 LA Tilburg the Netherlands

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Dewilde, W., Breet, N., Koolen, J.J. et al. ‘Ins’ and ‘outs’ of triple therapy. NHJL 18, 444–450 (2010). https://doi.org/10.1007/BF03091812

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