Deyan Yang, Quan Fang. Anticoagulation Strategy in Patients with Atrial Fibrillation and Coronary Artery Disease[J]. Medical Journal of Peking Union Medical College Hospital, 2018, 9(2): 118-122. doi: 10.3969/j.issn.1674-9081.2018.02.005
Citation: Deyan Yang, Quan Fang. Anticoagulation Strategy in Patients with Atrial Fibrillation and Coronary Artery Disease[J]. Medical Journal of Peking Union Medical College Hospital, 2018, 9(2): 118-122. doi: 10.3969/j.issn.1674-9081.2018.02.005

Anticoagulation Strategy in Patients with Atrial Fibrillation and Coronary Artery Disease

doi: 10.3969/j.issn.1674-9081.2018.02.005
More Information
  • Corresponding author: FANG Quan   Tel: 010- 69155068, E-mail: quanfangxjn2013@163.com
  • Received Date: 2017-12-29
  • Publish Date: 2018-03-30
  • Both coronary artery disease and atrial fibrillation are common diseases. Ischemic stroke and systemic embolism are major adverse outcomes of atrial fibrillation, and antithrombotic treatment reduces the risk of thromboembolic events significantly. On the other hand, antiplatelet therapy is essential in patients with coronary artery disease. Combined antiplatelet-anticoagulant therapy is required to reduce the risk of recurrent ischemic cardiac events and stroke in patients with atrial fibrillation coexisting with coronary artery disease. However, this antithrombotic strategy is associated with an increased risk of bleeding complications. It is challenging in clinical practice to balance the risk of bleeding and thromboembolism, and to choose from oral anticoagulants and antiplatelet agents to establish an optimal strategy.
  • loading
  • [1] Lip GY, Laroche C, Dan GA, et al. A prospective survey in European Society of Cardiology member countries of atrial fibrillation management: baseline results of EUR Observational Research Programme Atrial Fibrillation (EORP-AF) Pilot General Registry[J]. Europace, 2014, 16:308-319. doi:  10.1093/europace/eut373
    [2] Kralev S, Schneider K, Lang S, et al. Incidence and severity of coronary artery disease in patients with atrial fibrillation undergoing first-time coronary angiography[J]. PLoS One, 2011, 6:e24964. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=Open J-Gate000003875738
    [3] Bassand JP, Accetta G, Camm AJ, et al. Two-year outcomes of patients with newly diagnosed atrial fibrillation: results from GARFIELD-AF[J]. Eur Heart J, 2016, 37:2882-2889. doi:  10.1093/eurheartj/ehw233
    [4] Schmitt J, Duray G, Gersh BJ, et al. Atrial fibrillation in acute myocardial infarction: a systematic review of the incidence, clinical features and prognostic implications[J]. Eur Heart J, 2009, 30:1038-1045. doi:  10.1093/eurheartj/ehn579
    [5] Valgimigli M, Bueno H, Byrne RA, et al. 2017 ESC focused update on dual antiplatelet therapy in coronary artery disease developed in collaboration with EACTS: the task force for dual antiplatelet therapy in coronary artery disease of the European Society of Cardiology (ESC) and of the European Association for Cardio-Thoracic Surgery (EACTS) [J]. Eur Heart J, 2018, 39:213-260. doi:  10.1093/eurheartj/ehx419
    [6] Kirchhof P, Benussi S, Kotecha D, et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS[J]. Eur Heart J, 2016, 37:2893-2962. doi:  10.1093/eurheartj/ehw210
    [7] Task Force Members, Montalescot G, Sechtem U, et al. 2013 ESC guidelines on the management of stable coronary artery disease: the Task Force on the management of stable coronary artery disease of the European Society of Cardiology[J]. Eur Heart J, 2013, 34:2949-3003. doi:  10.1093/eurheartj/eht296
    [8] Roffi M, Patrono C, Collet JP, et al. 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: task force for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation of the European Society of Cardiology (ESC) [J]. Eur Heat J, 2016, 37:267-315. doi:  10.1093/eurheartj/ehv320
    [9] Ibanez B, James S, Agewall S, et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC) [J]. Eur Heart J, 2018, 39:119-177. doi:  10.1093/eurheartj/ehx393
    [10] Lamberts M, Gislason GH, Lip GY, et al. Antiplatelet therapy for stable coronary artery disease in atrial fibrillation patients taking an oral anticoagulant: a nationwide cohort study[J]. Circulation, 2014, 129:1577-1585. doi:  10.1161/CIRCULATIONAHA.113.004834
    [11] 袁勋, 王文尧, 张阔, 等.冠心病合并心房颤动患者经皮冠状动脉介入治疗术后抗血小板抗凝治疗策略[J].中国循环杂志, 2015, 30:723-727. doi:  10.3969/j.issn.1000-3614.2015.08.002
    [12] 中国老年学学会心脑血管病专业委员会, 中国康复医学会心脑血管病专业委员会.稳定性冠心病口服抗血小板药物治疗中国专家共识[J].中华心血管病杂志, 2016, 44:104-111. doi:  10.3760/cma.j.issn.0253-3758.2016.02.006
    [13] 中华医学会心血管病学分会介入心脏病学组, 中国医师协会心血管内科医师分会, 血栓防治专业委员会, 等.中国经皮冠状动脉介入治疗指南(2016)[J].中华心血管病杂志, 2016, 44:382-400. doi:  10.3760/cma.j.issn.0253-3758.2016.05.006
    [14] Lamberts M, Olesen JB, Ruwald MH, et al. Bleeding after initiation of multiple antithrombotic drugs, including triple therapy, in atrial fibrillation patients following myocardial infarction and coronary intervention: a nationwide cohort study[J]. Circulation, 2012, 126:1185-1193. doi:  10.1161/CIRCULATIONAHA.112.114967
    [15] Dans AL, Connolly SJ, Wallentin L, et al. Concomitant use of antiplatelet therapy with dabigatran or warfarin in the Randomized Evaluation of Long-Term Anticoagulation Therapy (RE-LY) trial[J]. Circulation, 2013, 127:634-640. doi:  10.1161/CIRCULATIONAHA.112.115386
    [16] Fiedler KA, Maeng M, Mehilli J, et al. Duration of triple therapy in patients requiring oral anticoagulation after drug-eluting stent implantation: the ISAR-TRIPLE trial[J]. J Am Coll Cardiol, 2015, 65:1619-1629. doi:  10.1016/j.jacc.2015.02.050
    [17] 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, randomised, controlled trial[J]. Lancet, 2013, 381:1107-1115. doi:  10.1016/S0140-6736(12)62177-1
    [18] Gibson CM, Mehran R, Bode C, et al. Prevention of bleeding in patients with atrial fibrillation undergoing PCI[J]. N Engl J Med, 2016, 375:2423-2434. doi:  10.1056/NEJMoa1611594
    [19] Cannon CP, Bhatt DL, Oldgren J, et al. Dual antithrombotic therapy with dabigatran after PCI in atrial fibrillation[J]. N Engl J Med, 2017, 37:1513-1524. http://europepmc.org/abstract/MED/28844193
    [20] Sarafoff N, Martischnig A, Wealer J, et al. Triple therapy with aspirin, prasugrel, and vitamin K antagonists in patients with drug-eluting stent implantation and an indication for oral anticoagulation[J]. J Am Coll Cardiol, 2013, 61:2060-2066. doi:  10.1016/j.jacc.2013.02.036
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Article Metrics

    Article views (332) PDF downloads(250) Cited by()
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return