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Review
. 2023 Jun 13:18:e22.
doi: 10.15420/icr.2022.40. eCollection 2023.

Is It Really Safe to Discontinue Antiplatelet Therapy 12 Months After Percutaneous Coronary Intervention in Patients with Atrial Fibrillation?

Balen Abdulrahman  1 , Richard J Jabbour  1 , Nick Curzen  1   2
Affiliations
Review

Is It Really Safe to Discontinue Antiplatelet Therapy 12 Months After Percutaneous Coronary Intervention in Patients with Atrial Fibrillation?

Balen Abdulrahman et al. Interv Cardiol. .

Abstract

The prevalence of AF in patients with coronary artery disease is high. The guidelines from many professional groups, including the European Society of Cardiology, American College of Cardiology/American Heart Association and Heart Rhythm Society, recommend a maximum duration of 12 months of combination single antiplatelet and anticoagulation therapy in patients who undergo percutaneous coronary intervention and who have concurrent AF, followed by anticoagulation alone beyond 1 year. However, the evidence that anticoagulation alone without antiplatelet therapy adequately reduces the well-documented attritional risk of stent thrombosis after coronary stent implantation is relatively sparse, particularly given that very late stent thrombosis (>1 year from stent implantation) is the commonest type. By contrast, the elevated risk of bleeding from combined anticoagulation and antiplatelet therapy is clinically important. The aim of this review is to assess the evidence for long-term anticoagulation alone without antiplatelet therapy 1 year post-percutaneous coronary intervention in patients with AF.

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Conflict of interest statement

Disclosure: NC has received research grants from Haemonetics, Heartflow, Boston Scientific, Beckmann Coulter, consulting fees from Abbott, honoraria from Abbott and Boston Scientific, support for attending meetings from Boston Scientific, Medtronic and Biosensors, has participated on an advisory board for Abbott, and is on the Interventional Cardiology editorial board; this did not influence peer review. All other authors have no conflicts of interest to declare.

Figures

Figure 1:
Figure 1:. Antithrombotic Regimen for Patients Undergoing Percutaneous Coronary Intervention with Indication for Oral Anticoagulation
See this image and copyright information in PMC

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