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Antithrombotic Therapy in Patients with Atrial Fibrillation and Acute Coronary Syndrome

by Wilbert Bor 1,* and Diana A. Gorog 2,3
1
St. Antonius Hospital, 3435 CM Nieuwegein, The Netherlands
2
Department of Medicine, National Heart & Lung Institute, Imperial College, London SW3 6LY, UK
3
Postgraduate Medical School, University of Hertfordshire, Hatfield AL10 9AB, UK
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(7), 2020; https://doi.org/10.3390/jcm9072020
Received: 30 May 2020 / Revised: 22 June 2020 / Accepted: 23 June 2020 / Published: 27 June 2020
(This article belongs to the Special Issue Antithrombotic Treatment of Acute Coronary Syndrome)
Acute coronary syndrome and atrial fibrillation are both common and can occur in the same patient. Combination therapy with dual antiplatelet therapy and oral anticoagulation increases risk of bleeding. Where the two conditions coexist, careful consideration is needed to determine the optimal antithrombotic treatment to reduce the risks of future ischaemic events associated with both conditions. Choices can be made in intraprocedural anticoagulation, type and dosing of oral anticoagulant, duration of combination therapy, and selection of P2Y12 inhibitor including genetic testing. This review article provides an overview of the available evidence to support clinicians in finding the delicate balance between antithrombotic efficacy and bleeding risk in patients with acute coronary syndrome and atrial fibrillation. View Full-Text
Keywords: atrial fibrillation; acute coronary syndrome; antithrombotic therapy; percutaneous coronary intervention; oral anticoagulants; antiplatelet therapy; dual therapy; triple therapy; vitamin K antagonist; NOAC atrial fibrillation; acute coronary syndrome; antithrombotic therapy; percutaneous coronary intervention; oral anticoagulants; antiplatelet therapy; dual therapy; triple therapy; vitamin K antagonist; NOAC
MDPI and ACS Style

Bor, W.; Gorog, D.A. Antithrombotic Therapy in Patients with Atrial Fibrillation and Acute Coronary Syndrome. J. Clin. Med. 2020, 9, 2020.

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