Tratamiento antitrombótico doble frente a triple

The management of antithrombotic treatment in patients who are receiving oral anticoagulants for atrial fibrillation and who are scheduled for a percutaneous coronary intervention is particularly complex, mainly because they have an elevated risk of bleeding due to their combined use of antiplatelet and anticoagulant agents. Despite the lack of evidence available in this setting, a number of clinical trials carried out in recent years have attempted to evaluate the safety and efficacy of triple antithrombotic therapy (i.e. dual antiplatelet therapy plus an anticoagulant drug) and dual antithrombotic therapy (i.e. a single antiplatelet agent plus an anticoagulant drug), both potentially based on vitamin K antagonists or direct oral anticoagulants. The aim of this article was to provide an overview of what is currently known about different approaches to triple and dual antithrombotic therapy in patients who are undergoing anticoagulation for nonvalvular atrial fibrillation and who are scheduled for percutaneous coronary intervention. In addition, some practical recommendations for the clinical management of these patients are made.

Supplement information: this article is part of a supplement entitled “Treatment of patients with atrial fibrillation undergoing percutaneous coronary intervention: an update”, which is sponsored by Boehringer Ingelheim.