Antithrombotic strategies in patients on long-term oral anticoagulation therapy undergoing percutaneous coronary intervention. ACS: acute coronary syndrome;

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Presentation transcript:

Antithrombotic strategies in patients on long-term oral anticoagulation therapy undergoing percutaneous coronary intervention. ACS: acute coronary syndrome; NOAC: non-vitamin K antagonist oral anticoagulant; PCI: percutaneous coronary intervention; OAC: ora... Antithrombotic strategies in patients on long-term oral anticoagulation therapy undergoing percutaneous coronary intervention. ACS: acute coronary syndrome; NOAC: non-vitamin K antagonist oral anticoagulant; PCI: percutaneous coronary intervention; OAC: oral anticoagulation; SCAD: stable coronary artery disease; VKA: vitamin K antagonist. aDual therapy with oral anticoagulation and single antiplatelet therapy (aspirin or clopidogrel) may be considered in selected patients at low ischaemic risk. bDual antiplatelet therapy (aspirin and clopidogrel) may be considered. cDual therapy with oral anticoagulation and aspirin (as an alternative to clopidogrel) may be considered. dDual therapy with oral anticoagulation and single antiplatelet therapy (aspirin or clopidogrel) up to 12 months may be considered in selected patients, particularly for patients managed medically or undergoing CABG. eDual therapy with oral anticoagulation and a single antiplatelet agent (aspirin or clopidogrel) may be considered in patients at very high risk of coronary events. fDual therapy with oral anticoagulation and clopidogrel may be considered in selected patients at low ischaemic risk. gTriple therapy with oral anticoagulation and dual antiplatelet therapy (aspirin and clopidogrel) may be considered up to 12 months in very selected patients at high risk of ischaemic events: prior stent thrombosis on adequate antiplatelet therapy, left main coronary artery or last remaining patent coronary artery stenting, multiple stenting in proximal coronary artery segments, two stents bifurcation treatment, or diffuse multivessel coronary artery disease, particularly in patients with diabetes mellitus. hChoice and dose of oral anticoagulants used in combination with antiplatelet therapy: Vitamin K antagonist (International Normalised Ratio 2-2,5); Dabigatran 110 mg once daily; Rivaroxaban 15 mg once daily; Apixaban 2,5 mg twice daily; Edoxaban 30 mg (or 15 mg) once daily. Sophie Degrauwe et al. Open Heart 2017;4:e000651 ©2017 by British Cardiovascular Society