ArticleClinical research in cardiology : official journal of the German Cardiac Society2013
Long-term safety and efficacy of dual therapy with oral anticoagulation and clopidogrel in patients with atrial fibrillation treated with drug-eluting stents.
Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.
- Antithrombotic Regimens for Patients Taking Oral Anticoagulation After Coronary Intervention: A Meta-analysis of 16 Clinical Trials and 9,185 Patients.Clinical cardiology · 2015Pooled it
- Antithrombotic Management in AF Patients Following Percutaneous Coronary Intervention: A European Perspective.Interventional cardiology (London, England) · 2023Review
- Mechanisms of ST-segment elevation myocardial infarction in patients with atrial fibrillation, prior stenting and long-standing chronic coronary syndrome.Cardiology journal · 2020Article
- Safety of percutaneous coronary intervention in patients with acute ischemic stroke/transient ischemic attack and acute coronary syndrome.Clinical research in cardiology : official journal of the German Cardiac Society · 2016Article
- Early results of first versus second generation Amplatzer occluders for left atrial appendage closure in patients with atrial fibrillation.Clinical research in cardiology : official journal of the German Cardiac Society · 2015Article
- Post-PCI Antithrombotic Therapy in Patients Requiring Long-Term Anticoagulation.Current cardiology reports · 2015Review
- A high ratio of ADP-TRAP induced platelet aggregation is associated more strongly with increased mortality after coronary stent implantation than high conventional ADP induced aggregation alone.Clinical research in cardiology : official journal of the German Cardiac Society · 2014Observational
- Dual antiplatelet therapy in the anticoagulated patient undergoing percutaneous coronary intervention risks, benefits, and unanswered questions.Current cardiology reports · 2014Review
- Impact of real-time contact force and impedance measurement in pulmonary vein isolation procedures for treatment of atrial fibrillation.Clinical research in cardiology : official journal of the German Cardiac Society · 2014Article
- Optimizing antithrombotic therapy after coronary stent implantation in patients on chronic oral anticoagulation.Journal of cardiovascular translational research · 2014Review
- Short-term outcome of patients with ST-segment elevation myocardial infarction (STEMI) treated with an everolimus-eluting bioresorbable vascular scaffold.Clinical research in cardiology : official journal of the German Cardiac Society · 2014Observational
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe optimal antithrombotic treatment for patients on oral anticoagulants (OAC) undergoing percutaneous coronary intervention (PCI) is controversial. We analyzed the safety and efficacy of dual therapy with OAC plus clopidogrel in atrial fibrillation (AF) patients receiving drug-eluting stents (DES). METHODS AND
resultsIn this retrospective analysis, all AF patients treated with dual therapy were retrospectively identified. Efficacy endpoints included cardiac death, myocardial infarction (MI), stent thrombosis (ST) and cerebrovascular stroke at follow-up, while safety was assessed by bleeding events defined by the Bleeding Academic Research Consortium (BARC). Between January 2008 and August 2010, 221 patients with high-risk AF received a DES and a dual therapy with OAC and clopidogrel. At a mean follow-up of 19 months, bleeding complications occurred in 22 patients (10 %), more than half of them (n = 12) were related to the index PCI. We observed 11 cardiac deaths (4.9 %), 9 MIs (4.1 %), 3 definite (1.4 %) and no probable ST at follow-up. All definite ST occurred after cessation of clopidogrel at 8, 22, and 30 months after PCI in patients not adequately anticoagulated. Eight patients (3.6 %) had an ischemic stroke, five of which after temporary or permanent cessation of OAC.
conclusionThe data generated from this large single-center experience in AF patients treated with DES revealed that dual therapy with OAC plus clopidogrel for 6-12 months followed by monotherapy with OAC appears both safe and effective at long-term follow-up. However, after clopidogrel cessation, maintaining therapeutic anticoagulation with an INR >2 is essential to prevent both thrombotic and embolic events.
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