Clinical & Experimental Cardiology
Open Access
ISSN: 2155-9880
ISSN: 2155-9880
Vivianne Chandrakesuma and Muhadi
Universitas Indonesia, Indonesia
Cipto Mangunkusumo National Hospital, Indonesia
Posters & Accepted Abstracts: J Clin Exp Cardiolog
Introduction & Aim: Atrial Fibrillation (AF) patients undergoing coronary stenting require both anticoagulant and antiplatelet for prevention of thrombosis and stroke. The standard triple therapy with vitamin K antagonist and Dual Antiplatelets Therapy (DAPT) reduces risk of stroke and thrombosis but carries high bleeding risk. Non-vitamin K Antagonist Oral Anticoagulants (NOACs) has proved to significantly reduce risk of bleeding in AF patients with similar efficacy to warfarin. Therefore, this report aims to learn whether NOACs lead to lower rates of bleeding compared to warfarin in AF patients after PCI. Method: A literature search was performed using PubMed, Cochrane Library and Ovid databases. Studies were included if they are written in English, published within the last 5 years, and are meta-analysis, RCTs, clinical trials or systematic review. The search resulted in 188 articles and two articles were considered eligible. The articles were critically appraised for their validity, importance and applicability. Result: In PIONEER-AF PCI trial, rivaroxaban 15 mg plus P2Y12 inhibitor and rivaroxaban 2.5 mg plus DAPT showed significantly lower rates of major and minor bleeding compared to warfarin ï�?« DAPT. RE-DUAL PCI trial showed dabigatran (110 mg and 150 mg) plus P2Y12 inhibitor led to significantly lower rates of major, clinically relevant nonmajor and total bleeding. Conclusion: Antithrombotic therapy with NOACs (Rivaroxaban 15 mg, Dabigatran 110 mg and 150 mg) plus P2Y12 inhibitor or Rivaroxaban 2.5 mg plus DAPT can be considered for AF patients after PCI as opposed to the standard triple therapy considering their lower rates of bleeding.
Vivianne Chandrakesuma is currently a 5th year Medical Student from University of Indonesia. She has completed her Bachelor of Medicine from University of Indonesia and Bachelor of Medical Science from University of Melbourne, Australia.
E-mail: vivianne.ch@hotmail.com