ArticleJournal of the American Heart Association2025
Contemporary Use and Clinical Significance of Initial Triple Versus Double Therapy After Percutaneous Coronary Intervention for Myocardial Infarction in Patients With Atrial Fibrillation.
Article in Journal of the American Heart Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed.
- Antithrombotic Therapy After PCI in High-Risk Cardiovascular Patients: Navigating Complexity Beyond Guidelines.Journal of clinical medicine · 2026Review
- From heart to brain: a Case Report of individualized antithrombotic management for left ventricular thrombus and stroke in a young patient with acute myocardial infarction.Frontiers in pharmacology · 2026Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
backgroundPatients with atrial fibrillation undergoing percutaneous coronary intervention (PCI) have traditionally received triple therapy (dual antiplatelet therapy and anticoagulation). More recent randomized trial evidence supports a strategy of double therapy (anticoagulant plus single antiplatelet agent), albeit after a brief triple therapy course. The safety of initiating double therapy immediately post-PCI remains unclear. METHODS AND
resultsThis study analyzed real-world prescribing patterns and outcomes of immediate double therapy versus initial triple therapy in patients with atrial fibrillation post-PCI using the Vizient Clinical Database. Patients with atrial fibrillation undergoing PCI for myocardial infarction (2016-2023) were categorized into 2 groups: triple therapy (aspirin, P2Y12 [purinergic receptor P2Y, G-protein coupled, 12 protein] inhibitor, and anticoagulant) or double therapy (anticoagulant and 1 antiplatelet agent) on day 1 post-PCI. The primary outcome was in-hospital mortality. Secondary outcomes included stent thrombosis, major bleeding, intracranial hemorrhage, and net clinical adverse events. Multivariable logistic regression and inverse probability of treatment weighting were used to compare outcomes. Among 29 226 patients, 16.3% received immediate double therapy on day 1 post-PCI, whereas 83.7% received triple therapy. Adjusted analyses showed no significant differences in in-hospital mortality (9.4% versus 9.2%, adjusted odds ratio [aOR], 1.05 [95% CI, 0.93-1.18]), major bleeding, intracranial hemorrhage, or net clinical adverse events. However, immediate double therapy was associated with higher odds of stent thrombosis (1.1% versus 0.8%; aOR, 1.48 [95% CI, 1.08-2.03]), particularly in patients with ST-segment-elevation myocardial infarction (2.0% versus 1.3%; aOR, 1.46 [95% CI, 1.001-2.13]).
conclusionsImmediate double therapy post-PCI is frequently used and appears safe for most patients with atrial fibrillation. Further studies are needed to identify high-risk subgroups, including those with ST-segment-elevation myocardial infarction, who may benefit from an initial short course of triple therapy.
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