Antiplatelet therapy strategies after percutaneous coronary intervention in patients needing oral anticoagulation
| Autor: | Laurent Fauchier, Denis Angoulvant, Christophe Saint Etienne, Edouard Simeon |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Aspirin
medicine.medical_specialty business.industry medicine.medical_treatment Percutaneous coronary intervention Atrial fibrillation Clopidogrel medicine.disease Surgery law.invention Randomized controlled trial law Internal medicine Antithrombotic Conventional PCI medicine Cardiology Molecular Medicine cardiovascular diseases Cardiology and Cardiovascular Medicine business Stroke medicine.drug |
| Zdroj: | Future Cardiology. 9:759-762 |
| ISSN: | 1744-8298 1479-6678 |
| DOI: | 10.2217/fca.13.77 |
| Popis: | Evaluation of: Dewilde WJ, Oirbans T, Verheugt FW et al. Use of clopidogrel with or without aspirin in patients taking oral anticoagulant therapy and undergoing percutaneous coronary intervention: an open-label, randomized, controlled trial. Lancet 381(9872), 1107–1115 (2013). Long-term oral anticoagulant (OAC) and dual-antiplatelet therapy are commonly needed in patients with atrial fibrillation and in patients undergoing percutaneous coronary intervention (PCI), respectively. The combination of atrial fibrilation and PCI is frequent, and leads to a dilemma for antithrombotic therapy, where risk of stroke or stent thrombosis must be balanced with bleeding risk. In the WOEST study, 573 patients on OAC undergoing PCI were randomly assigned to receive clopidogrel alone or clopidogrel plus aspirin. The primary end point was the occurrence of any bleeding episode during 1-year follow-up. Clopidogrel alone administered to patients taking OAC after PCI was associated with a significantly lower rate of bleeding complications than clopidogrel plus aspirin. Moreover, a composite secondary end point of death, myocardial infarction and stent thrombosis was significantly lower in the dual-therapy group compared with the triple-therapy group. In spite of its limitations, the WOEST study constitutes a major breakthrough, showing that long-term aspirin after PCI may be obsolete in certain circumstances. This needs to be confirmed in further studies. |
| Databáze: | OpenAIRE |
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