Intervención coronaria en pacientes con fibrilación auricular

Patients with atrial fibrillation and coronary artery disease often have an elevated risk of both ischemia and bleeding. In the context of oral anticoagulation, clopidogrel is the P2Y₁₂ inhibitor with the best safety profile. However, although it is recommended for patients with acute coronary syndromes, there is still some debate today about whether it should be used for pretreatment before invasive procedures. In patients scheduled to undergo an elective percutaneous coronary intervention, heparin bridging before the procedure is not recommended because this approach has been associated with an increased incidence of adverse events. Radial access should be preferred in the majority of cases when hemodynamics and the coronary anatomy permit. Although the evidence is still limited, it is recommended that low-dose unfractionated heparin should be administered during the procedure.

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.