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Thromb Haemost 2011; 106(04): 571-584
DOI: 10.1160/TH11-04-0262
Consensus Document
Schattauer GmbH

Consensus Document: Antithrombotic therapy in patients with atrial fibrillation undergoing coronary stenting[*]

A North-American perspective
David P. Faxon
1   Division of Cardiology, Brigham and Women’s Hospital, Boston, Massachusetts, USA
,
John W. Eikelboom
2   Department of Medicine, Hamilton Health Sciences and McMaster University, Hamilton, Ontario, Canada
,
Peter B. Berger
3   Geisinger Clinic, Danville, Pennsylvania, USA
,
David R. Holmes
4   Mayo Clinic, Rochester, Minnesota, USA
,
Deepak L. Bhatt
5   Division of Cardiology, VA Boston Health System, Boston, Massachusetts, USA
,
David J. Moliterno
6   Gill Heart Institute and Division of Cardiovascular Medicine, University of Kentucky, Lexington, Kentucky, USA
,
Richard C. Becker
7   Divisions of Cardiology and Hematology, Duke University School of Medicine, Durham, North Carolina, USA
,
Dominick J. Angiolill
8   Division of Cardiology, University of Florida College of Medicine-Jacksonville, Jacksonville, Florida, USA
› Author Affiliations
Further Information

Publication History

Received: 21 April 2011

Accepted after major revision: 05 July 2011

Publication Date:
15 December 2017 (online)

Also available at
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Summary

The optimal regimen of the anticoagulant and antiplatelet therapies in patients with atrial fibrillation who have had a coronary stent is unclear. It is well recognised that “triple therapy” with aspirin, clopidogrel, and warfarin is associated with an increased risk of bleeding. National guidelines have not made specific recommendations given the lack of adequate data. In choosing the best antithrombotic options for a patient, consideration needs to be given to the risks of stroke, stent thrombosis and major bleeding. This document describes these risks, provides specific recommendations concerning vascular access, stent choice, concomitant use of proton-pump inhibitors and the use and duration of triple therapy following stent placement based upon the risk assessment.

Keywords

Atrial fibrillation - antithrombotic therapy - warfarin - triple therapy - stent

* An Executive Summary of this article will be published in the journal Circulation: Cardiovascular Interventions.


 

  • References

  • 1 Holmes Jr. DR, Kereiakes DJ, Kleiman NS. et al. Combining antiplatelet and anticoagulant therapies. J Am Coll Cardiol 2009; 54: 95-109.
    CrossrefPubMedGoogle Scholar
  • 2 Paikin JS, Wright DS, Crowther MA. et al. Triple antithrombotic therapy in patients with atrial fibrillation and coronary artery stents. Circulation 2010; 121: 2067-2070.
    CrossrefPubMedGoogle Scholar
  • 3 Rossini R, Musumeci G, Lettieri C. et al. Long-term outcomes in patients undergoing coronary stenting on dual oral antiplatelet treatment requiring oral anticoagulant therapy. Am J Cardiol 2008; 102: 1618-1623.
    CrossrefPubMedGoogle Scholar
  • 4 Wang TY, Robinson LA, Ou FS. et al. Discharge antithrombotic strategies among patients with acute coronary syndrome previously on warfarin anticoagulation: physician practice in the CRUSADE registry. Am Heart J 2008; 155: 361-368.
    CrossrefPubMedGoogle Scholar
  • 5 Rubboli A, Colletta M, Valencia J. et al. Periprocedural management and in-hospital outcome of patients with indication for oral anticoagulation undergoing coronary artery stenting. J Interv Cardiol 2009; 22: 390-397.
    CrossrefPubMedGoogle Scholar
  • 6 Sørensen R, Hansen ML, Abildstrom SZ. et al. Risk of bleeding in patients with acute myocardial infarction treated with different combinations of aspirin, clopidogrel, and vitamin K antagonists in Denmark: a retrospective analysis of nationwide registry data. Lancet 2009; 374: 1967-1974.
    CrossrefPubMedGoogle Scholar
  • 7 Rao SV, Pieper KS, Granger CB. et al. Impact of bleeding severity on clinical outcomes amoung patients with acute coronary syndromes. Am J Cardiol 2005; 96: 1200-1206.
    CrossrefPubMedGoogle Scholar
  • 8 Manoukian SV, Mehran R, Voeltz MD. et al. Impact of major bleeding on 30-day mortality and clinical outcomes in patients with acute coronary symdormes. An analysis from the ACUITY trial. J Am Coll Cardiol 2007; 49: 1362-1368.
    CrossrefPubMedGoogle Scholar
  • 9 Rogacka R, Chieffo A, Michev I. et al. Dual antiplatelet therapy after percutaneous coronary intervention with stent implantation in patients taking chronic oral anticoagulation. JACC Cardiovasc Interv 2008; 1: 56-61.
    CrossrefPubMedGoogle Scholar
  • 10 Fuster V, Ryden LE, Cannom DS. et al. ACC/AHA/ESC 2006 Guidelines for the Management of Patients with Atrial Fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation): developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. Circulation 2006; 114: e257-354.
    PubMedGoogle Scholar
  • 11 Wann LS, Curtis AB, January CT. et al. 2011 ACCF/AHA/HRS focused update on the management of patients with atrial fibrillation (updating the 2006 guideline): a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation 2011; 123: 104-123.
    CrossrefPubMedGoogle Scholar
  • 12 Lip GY, Huber K, Andreotti F. et al. Management of antithrombotic therapy in atrial fibrillation patients presenting with acute coronary syndrome and/or undergoing percutaneous coronary intervention/ stenting. Thromb Haemost 2010; 103: 13-28.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 13 Lip GY, Huber K, Andreotti F. et al. Antithrombotic management of atrial fibrillation patients presenting with acute coronary syndrome and/or undergoing coronary stenting: executive summary--a Consensus Document of the European Society of Cardiology Working Group on Thrombosis, endorsed by the European Heart Rhythm Association (EHRA) and the European Association of Percutaneous Cardiovascular Interventions (EAPCI). Eur Heart J 2010; 31: 1311-1318.
    CrossrefPubMedGoogle Scholar
  • 14 Camm AJ, Kirchhof P, Lip GY. et al. Guidelines for the management of atrial fibrillation: the Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). Eur Heart J 2010; 31: 2369-2429.
    CrossrefPubMedGoogle Scholar
  • 15 Fuster V, Ryden LE, Cannom DS. et al. 2011 ACCF/AHA/HRS Focused Updates Incorporated Into the ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation 2011; 123: e269-367.
    CrossrefPubMedGoogle Scholar
  • 16 McNamara RL, Tamariz LJ, Segal JB, Bass EB. Management of atrial fibrillation: review of the evidence for the role of pharmacologic therapy, electrical cardioversion, and echocardiography. Ann Inter Med 2003; 139: 1018-1033.
    CrossrefPubMedGoogle Scholar
  • 17 Hart RG, Pearce LA, Aguilar MI. Meta-analysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation. Ann Intern Med 2007; 146: 857-867.
    CrossrefPubMedGoogle Scholar
  • 18 Clopidogrel plus aspirin versus oral anticoagulation for atrial fibrillation in the Atrial fibrillation Clopidogrel Trial with Irbesartan for prevention of Vascular Events (ACTIVE W): a randomised controlled trial. Lancet 2006; 367: 1903-1912.
    CrossrefPubMedGoogle Scholar
  • 19 Depta JP, Bhatt DL. Atherothrombosis and atrial fibrillation: Important and often overlapping clinical syndromes. Thromb Haemost 2010; 104: 657-663.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 20 van Werkum JW, Heestermans AA, Zomer AC. et al. Predictors of coronary stent thrombosis: the Dutch Stent Thrombosis Registry. J Am Coll Cardiol 2009; 53: 1399-1409.
    CrossrefPubMedGoogle Scholar
  • 21 Ruiz-Nodar JM, Marin F, Hurtado JA. et al. Anticoagulant and antiplatelet therapy use in 426 patients with atrial fibrillation undergoing percutaneous coronary intervention and stent implantation implications for bleeding risk and prognosis. J Am Coll Cardiol 2008; 51: 818-825.
    CrossrefPubMedGoogle Scholar
  • 22 Gage BF, Waterman AD, Shannon W. et al. Validation of clinical classification schemes for predicting stroke: results from the National Registry of Atrial Fibrillation. J Am Med Assoc 2001; 285: 2864-2870.
    CrossrefPubMedGoogle Scholar
  • 23 Go AS, Hylek EM, Chang Y. et al. Anticoagulation therapy for stroke prevention in atrial fibrillation: how well do randomized trials translate into clinical practice?. J Am Med Assoc 2003; 290: 2685-2692.
    CrossrefPubMedGoogle Scholar
  • 24 Lip GY, Nieuwlaat R, Pisters R. et al. Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: the euro heart survey on atrial fibrillation. Chest 2010; 137: 263-272.
    CrossrefPubMedGoogle Scholar
  • 25 Olesen JB, Lip GYH, Hansen ML. et al. Validation of risk stratification schemes for predicting stroke and thromboembolism in patients with atrial fibrillation: nationwide cohort study. Br Med J 2011; 342: d124.
    CrossrefPubMedGoogle Scholar
  • 26 Connolly SJ, Pogue J, Eikelboom J. et al. Benefit of oral anticoagulant over antiplatelet therapy in atrial fibrillation depends on the quality of international normalized ratio control achieved by centers and countries as measured by time in therapeutic range. Circulation 2008; 118: 2029-2037.
    CrossrefPubMedGoogle Scholar
  • 27 de la Torre-Hernandez JM, Alfonso F, Hernandez F. et al. Drug-eluting stent thrombosis: results from the multicenter Spanish registry ESTROFA (Estudio ESpanol sobre TROmbosis de stents FArmacoactivos). J Am Coll Cardiol 2008; 51: 986-990.
    CrossrefPubMedGoogle Scholar
  • 28 Wenaweser P, Rey C, Eberli FR. et al. Stent thrombosis following bare-metal stent implantation: success of emergency percutaneous coronary intervention and predictors of adverse outcome. Eur Heart J 2005; 26: 1180-1187.
    CrossrefPubMedGoogle Scholar
  • 29 Ong AT, Hoye A, Aoki J. et al. Thirty-day incidence and six-month clinical outcome of thrombotic stent occlusion after bare-metal, sirolimus, or paclitaxel stent implantation. J Am Coll Cardiol 2005; 45: 947-953.
    CrossrefPubMedGoogle Scholar
  • 30 Roukoz H, Bavry AA, Sarkees ML. et al. Comprehensive meta-analysis on drug-eluting stents versus bare-metal stents during extended follow-up. Am J Med 2009; 122: 581 e1-10.
    CrossrefPubMedGoogle Scholar
  • 31 Kirtane AJ, Gupta A, Iyengar S. et al. Safety and efficacy of drug-eluting and bare metal stents: comprehensive meta-analysis of randomized trials and observational studies. Circulation 2009; 119: 3198-3206.
    CrossrefPubMedGoogle Scholar
  • 32 Stone GW, Ellis SG, Colombo A. et al. Offsetting impact of thrombosis and restenosis on the occurrence of death and myocardial infarction after paclitaxel-eluting and bare metal stent implantation. Circulation 2007; 115: 2842-2847.
    CrossrefPubMedGoogle Scholar
  • 33 Iakovou I, Schmidt T, Bonizzoni E. et al. Incidence, predictors, and outcome of thrombosis after successful implantation of drug-eluting stents. J Am Med Assoc 2005; 293: 2126-2130.
    CrossrefPubMedGoogle Scholar
  • 34 Spertus JA, Kettelkamp R, Vance C. et al. Prevalence, predictors, and outcomes of premature discontinuation of thienopyridine therapy after drug-eluting stent placement: results from the PREMIER registry. Circulation 2006; 113: 2803-2809.
    CrossrefPubMedGoogle Scholar
  • 35 Airoldi F, Colombo A, Morici N. et al. Incidence and predictors of drug-eluting stent thrombosis during and after discontinuation of thienopyridine treatment. Circulation 2007; 116: 745-754.
    CrossrefPubMedGoogle Scholar
  • 36 Kandzari DE, Angiolillo DJ, Price MJ. et al. Identifying the „optimal” duration of dual antiplatelet therapy after drug-eluting stent revascularization. JACC Cardiovasc Interv 2009; 2: 1279-1285.
    CrossrefPubMedGoogle Scholar
  • 37 Rabinovitz A, Bier DM, Wagman GM. et al. Association between off-label use of drug-eluting stents and subsequent stent thrombosis: a case-control analysis. J Inv Cardiol 2010; 22: 15-19.
    PubMedGoogle Scholar
  • 38 Danga GD, Mehran R, Parise H. et al. Stent thrombosis after percutaneous coronary intervention in acute myocardila infraction: The HORIZONS-AMI trial. Circulation. 2011 in press.
    PubMedGoogle Scholar
  • 39 Kushner FG, Hand M, Smith Jr. SC. et al. 2009 Focused Updates: ACC/AHA Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction (updating the 2004 Guideline and 2007 Focused Update) and ACC/AHA/ SCAI Guidelines on Percutaneous Coronary Intervention (updating the 2005 Guideline and 2007 Focused Update): a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation 2009; 120: 2271-2306.
    CrossrefPubMedGoogle Scholar
  • 40 Anderson JL, Adams CD, Antman EM. et al. 2011 ACCF/AHA Focused Update Incorporated Into the ACC/AHA 2007 Guidelines for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2011 in press.
    PubMedGoogle Scholar
  • 41 Cosmi B, Rubboli A, Castelvetri C, Milandri M. Ticlopidine versus oral anticoagulation for coronary stenting. Cochrane Database Syst Rev. 2001 CD002133.
    PubMedGoogle Scholar
  • 42 Leon MB, Baim DS, Popma JJ. et al. A clinical trial comparing three antithrombotic-drug regimens after coronary-artery stenting. Stent Anticoagulation Restenosis Study Investigators. New Engl J Med 1998; 339: 1665-1671.
    CrossrefPubMedGoogle Scholar
  • 43 Bertrand ME, Rupprecht HJ, Urban P. et al. Double-blind study of the safety of clopidogrel with and without a loading dose in combination with aspirin compared with ticlopidine in combination with aspirin after coronary stenting : the clopidogrel aspirin stent international cooperative study (CLASSICS). Circulation 2000; 102: 624-629.
    CrossrefPubMedGoogle Scholar
  • 44 Bhatt DL, Bertrand ME, Berger PB. et al. Meta-analysis of randomized and registry comparisons of ticlopidine with clopidogrel after stenting. J Am Coll Cardiol 2002; 39: 9-14.
    PubMedGoogle Scholar
  • 45 Angiolillo DJ, Fernandez-Ortiz A, Bernardo E. et al. Variability in individual responsiveness to clopidogrel: clinical implications, management, and future perspectives. J Am Coll Cardiol 2007; 49: 1505-1516.
    CrossrefPubMedGoogle Scholar
  • 46 Angiolillo DJ, Shoemaker SB, Desai B. et al. Randomized comparison of a high clopidogrel maintenance dose in patients with diabetes mellitus and coronary artery disease: results of the Optimizing Antiplatelet Therapy in Diabetes Mellitus (OPTIMUS) study. Circulation 2007; 115: 708-716.
    CrossrefPubMedGoogle Scholar
  • 47 Mehta SR, Bassand JP, Chrolavicius S. et al. Dose comparisons of clopidogrel and aspirin in acute coronary syndromes. New Engl J Med 2010; 363: 930-942.
    CrossrefPubMedGoogle Scholar
  • 48 Mehta SR, Tanguay JF, Eikelboom JW. et al. Double-dose versus standard-dose clopidogrel and high-dose versus low-dose aspirin in individuals undergoing percutaneous coronary intervention for acute coronary syndromes (CURRENT-OASIS 7): a randomised factorial trial. Lancet 2010; 376: 1233-1243.
    CrossrefPubMedGoogle Scholar
  • 49 Wiviott SD, Braunwald E, McCabe CH. et al. Prasugrel versus clopidogrel in patients with acute coronary syndromes. New Engl J Med 2007; 357: 2001-2015.
    CrossrefPubMedGoogle Scholar
  • 50 Wallentin L, Becker RC, Budaj A. et al. Ticagrelor versus clopidogrel in patients with acute coronary syndromes. New Engl J Med 2009; 361: 1045-1057.
    CrossrefPubMedGoogle Scholar
  • 51 Mehran R, Pocock SJ, Nikolsky E. et al. A risk score to predict bleeding in patients with acute coronary syndromes. J Am Coll Cardiol 2010; 55: 2556-2566.
    CrossrefPubMedGoogle Scholar
  • 52 Steinhubl SR, Kastrati A, Berger PB. Variation in the definitions of bleeding in clinical trials of patients with acute coronary syndromes and undergoing percutaneous coronary interventions and its impact on the apparent safety of anti-thrombotic drugs. Am Heart J 2007; 154: 3-11.
    CrossrefPubMedGoogle Scholar
  • 53 Mehran R, Rao SV, Bhatt DL. et al. Standarized definitions for cardiovascular clinical trials: A consensus report fromteh bleeding academic research consortium (BARC). Circulation 2011; 123: 736-747.
    PubMedGoogle Scholar
  • 54 Fang MC, Go AS, Chang Y. et al. Death and disability from warfarin-associated intracranial and extracranial hemorrhages. Am J Med 2007; 120: 700-705.
    CrossrefPubMedGoogle Scholar
  • 55 Pisters R, Lane DA, Nieuwlaat R. et al. A novel user-friendly score (HAS-BLED) to assess 1-year risk of major bleeding in patients with atrial fibrillation: the Euro Heart Survey. Chest 2010; 138: 1093-1100.
    CrossrefPubMedGoogle Scholar
  • 56 Lip GY, Frison L, Halperin JL. et al. Comparative validation of a novel risk score for predicting bleeding risk in anticoagulated patients with atrial fibrillation: the HAS-BLED (Hypertension, Abnormal Renal/Liver Function, Stroke, Bleeding History or Predisposition, Labile INR, Elderly, Drugs/Alcohol Concomitantly) score. J Am Coll Cardiol 2011; 57: 173-180.
    CrossrefPubMedGoogle Scholar
  • 57 Anderson JL, Horne BD, Stevens SM. et al. Randomized trial of genotype-guided versus standard warfarin dosing in patients initiating oral anticoagulation. Circulation 2007; 116: 2563-2570.
    CrossrefPubMedGoogle Scholar
  • 58 Kangelaris KN, Bent S, Nussbaum RL. et al. Genetic testing before anticoagulation? A systematic review of pharmacogenetic dosing of warfarin. J Gen Int Med 2009; 24: 656-664.
    CrossrefPubMedGoogle Scholar
  • 59 Bhatt DL, Flather MD, Hacke W. et al. Patients with prior myocardial infarction, stroke, or symptomatic peripheral arterial disease in the CHARISMA trial. J Am Coll Cardiol 2007; 49: 1982-1988.
    CrossrefPubMedGoogle Scholar
  • 60 Berger PB, Bhatt DL, Fuster V. et al. Bleeding complications with dual antiplatelet therapy among patients with stable vascular disease or risk factors for vascular disease: results from the Clopidogrel for High Atherothrombotic Risk and Ischemic Stabilization, Management, and Avoidance (CHARISMA) trial. Circulation 2010; 121: 2575-2583.
    CrossrefPubMedGoogle Scholar
  • 61 Antman EM WS, Murphy SA, Voitk J. et al. Early and late benefits fo prasugrel in petient swith acute coronary syndromes undergoing percutaneous coronary intervention. J Am Coll Cardiol 2008; 51: 2020-2033.
    PubMedGoogle Scholar
  • 62 Buresly K, Eisenberg MJ, Zhang X. et al. Bleeding complications associated with combinations of aspirin, thienopyridine derivatives, and warfarin in elderly patients following acute myocardial infarction. Arch Intern Med 2005; 165: 784-789.
    CrossrefPubMedGoogle Scholar
  • 63 Gao F, Zhou YJ, Wang ZJ. et al. Comparison of different antithrombotic regimens for patients with atrial fibrillation undergoing drug-eluting stent implantation. Circ J 2010; 74: 701-708.
    CrossrefPubMedGoogle Scholar
  • 64 Jolly SS, Amlani S, Hamon M, Yusuf S, Mehta SR. Radial versus femoral access for coronary angiography or intervention and the impact on major bleeding and ischemic events: a systematic review and meta-analysis of randomized trials. Am Heart J 2009; 157: 132-140.
    CrossrefPubMedGoogle Scholar
  • 65 Rao SV, Cohen MG, Kandzari DE. et al. The transradial approach to percutaneous coronary intervention: historical perspective, current concepts, and future directions. J Am Coll Cardiol 2010; 55: 2187-2195.
    CrossrefPubMedGoogle Scholar
  • 66 Sanjit S, Jolly SY, Cairns J. et al. for the, group* Rt. Radial versus femoral access for coronary angiography and intervention in patients with acute coronary syndromes (RIVAL): a randomised, parallel group, multicentre trial. Lancet 2011; 6736: 1-12.
    PubMedGoogle Scholar
  • 67 Verheugt FS SS, Hamon M, Darius H. et al. Incidence, prognostic impact and influence of antithrombotic therapy on access and nonaccess site bleeding in percutaneous coronary intervention. JACC Cardiovasc Interv 2011; 4: 191-197.
    CrossrefPubMedGoogle Scholar
  • 68 Kastrati A, Mehilli J, Neumann FJ. et al. Abciximab in patients with acute coronary syndromes undergoing percutaneous coronary intervention after clopidogrel pretreatment: the ISAR-REACT 2 randomized trial. J Am Med Assoc 2006; 295: 1531-1538.
    CrossrefPubMedGoogle Scholar
  • 69 ten Berg JM, Kelder JC, Suttorp MJ. et al. Effect of coumarins started before coronary angioplasty on acute complications and long-term follow-up: a randomized trial. Circulation 2000; 102: 386-391.
    CrossrefPubMedGoogle Scholar
  • 70 Marso SP, Amin AP, House JA. et al. Association between use of bleeding avoidance strategies and risk of periprocedural bleeding among patients undergoing percutaneous coronary intervention. J Am Med Assoc 2010; 303: 2156-2164.
    CrossrefPubMedGoogle Scholar
  • 71 Cantor WJ, Peterson ED, Popma JJ. et al. Provisional stenting strategies: systematic overview and implications for clinical decision-making. J Am Coll Cardiol 2000; 36: 1142-1151.
    CrossrefPubMedGoogle Scholar
  • 72 Leon MB, Kandzari DE, Eisenstein EL. et al. Late safety, efficacy, and cost-effectiveness of a zotarolimus-eluting stent compared with a paclitaxel-eluting stent in patients with de novo coronary lesions: 2-year follow-up from the ENDEAVOR IV trial (Randomized, Controlled Trial of the Medtronic Endeavor Drug [ABT-578] Eluting Coronary Stent System Versus the Taxus Paclitaxel-Eluting Coronary Stent System in De Novo Native Coronary Artery Lesions). JACC Cardiovasc Interv 2009; 2: 1208-1218.
    CrossrefPubMedGoogle Scholar
  • 73 Caixeta A, Lansky AJ, Serruys PW. et al. Clinical follow-up 3 years after everolimus- and paclitaxel-eluting stents: a pooled analysis from the SPIRIT II (A Clinical Evaluation of the XIENCE V Everolimus Eluting Coronary Stent System in the Treatment of Patients With De Novo Native Coronary Artery Lesions) and SPIRIT III (A Clinical Evaluation of the Investigational Device XIENCE V Everolimus Eluting Coronary Stent System [EECSS] in the Treatment of Subjects With De Novo Native Coronary Artery Lesions) randomized trials. JACC Cardiovasc Interv 2010; 3: 1220-1228.
    CrossrefPubMedGoogle Scholar
  • 74 Park KW, Yoon JH, Kim JS. et al. Efficacy of Xience/promus versus Cypher in rEducing Late Loss after stENTing (EXCELLENT) trial: study design and rationale of a Korean multicenter prospective randomized trial. Am Heart J 2009; 157: 811-817e1.
    CrossrefPubMedGoogle Scholar
  • 75 Abraham NS, Hlatky MA, Antman EM. et al. ACCF/ACG/AHA 2010 Expert Consensus Document on the concomitant use of proton pump inhibitors and thienopyridines: a focused update of the ACCF/ACG/AHA 2008 expert consensus document on reducing the gastrointestinal risks of antiplatelet therapy and NSAID use: a report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents. Circulation 2010; 122: 2619-2633.
    CrossrefPubMedGoogle Scholar
  • 76 Lanas A, Baron JA, Sandler RS. et al. Peptic ulcer and bleeding events associated with rofecoxib in a 3-year colorectal adenoma chemoprevention trial. Gastroenterology 2007; 132: 490-497.
    CrossrefPubMedGoogle Scholar
  • 77 Ray WA, Murray KT, Griffin MR. et al. Outcomes with concurrent use of clopidogrel and proton-pump inhibitors: a cohort study. Ann Intern Med 2010; 152: 337-345.
    CrossrefPubMedGoogle Scholar
  • 78 Angiolillo DJ, Gibson CM, Cheng S. et al. Differential effects of omeprazole and pantoprazole on the pharmacodynamics and pharmacokinetics of clopidogrel in healthy subjects: randomized, placebo-controlled, crossover comparison studies. Clinical Pharmacol Therap 2011; 89: 65-74.
    PubMedGoogle Scholar
  • 79 O'Donoghue ML, Braunwald E, Antman EM. et al. Pharmacodynamic effect and clinical efficacy of clopidogrel and prasugrel with or without a proton-pump inhibitor: an analysis of two randomised trials. Lancet 2009; 374: 989-997.
    CrossrefPubMedGoogle Scholar
  • 80 Siller-Matula JM, Jilma B, Schror K, Christ G, Huber K. Effect of proton pump inhibitors on clinical outcome in patients treated with clopidogrel: a systematic review and meta-analysis. J Thromb Haemost 2010; 8: 2624-2641.
    CrossrefPubMedGoogle Scholar
  • 81 Bhatt DL, Cryer BL, Contant CF. et al. Clopidogrel with or without omeprazole in coronary artery disease. New Engl J Med 2010; 363: 1909-1917.
    CrossrefPubMedGoogle Scholar
  • 82 Lai KC, Lam SK, Chu KM. et al. Lansoprazole for the prevention of recurrences of ulcer complications from long-term low-dose aspirin use. New Engl J Med 2002; 346: 2033-2038.
    CrossrefPubMedGoogle Scholar
  • 83 Yeomans N, Lanas A, Labenz J. et al. Efficacy of esomeprazole (20 mg once daily) for reducing the risk of gastroduodenal ulcers associated with continuous use of low-dose aspirin. Am J Gastroenterol 2008; 103: 2465-2473.
    CrossrefPubMedGoogle Scholar
  • 84 A randomised, blinded, trial of clopidogrel versus aspirin in patients at risk of ischaemic events (CAPRIE). Lancet 1996; 348: 1329-1339.
    CrossrefPubMedGoogle Scholar
  • 85 Nguyen MC, Lim YL, Walton A. et al. Combining warfarin and antiplatelet therapy after coronary stenting in the Global Registry of Acute Coronary Events: is it safe and effective to use just one antiplatelet agent?. Eur Heart J 2007; 28: 1717-1722.
    CrossrefPubMedGoogle Scholar
  • 86 Karjalainen PP, Porela P, Ylitalo A. et al. Safety and efficacy of combined antiplatelet-warfarin therapy after coronary stenting. Eur Heart J 2007; 28: 726-732.
    CrossrefPubMedGoogle Scholar
  • 87 Angiolillo DJ, Ueno M, Goto S. Basic principles of platelet biology and clinical implications. Circ J 2010; 74: 597-607.
    CrossrefPubMedGoogle Scholar
  • 88 Bhatt DL, Hirsch AT, Ringleb PA. et al. Reduction in the need for hospitalization for recurrent ischemic events and bleeding with clopidogrel instead of aspirin. CAPRIE investigators. Am Heart J 2000; 140: 67-73.
    CrossrefPubMedGoogle Scholar
  • 89 Hansen ML, Sorensen R, Clausen MT. et al. Risk of bleeding with single, dual, or triple therapy with warfarin, aspirin, and clopidogrel in patients with atrial fibrillation. Arch Intern Med 2010; 170: 1433-1441.
    PubMedGoogle Scholar
  • 90 Anaya P, Moliterno DJ. Patient, Heal Thyself: The Ongoing Evolution of Patient Self-directed Care and Hand-Held Technology. Ann Int Med 2011; 154: 500-501.
    CrossrefPubMedGoogle Scholar
  • 91 Connolly SJ, Ezekowitz MD, Yusuf S. et al. Dabigatran versus warfarin in patients with atrial fibrillation. New Engl J Med 2009; 361: 1139-1151.
    CrossrefPubMedGoogle Scholar
  • 92 Eikelboom JW, Connolly SJ, Ezekowitz M. et al. The risk of bleeding with two doses of dabigatran compared to warfarin in older and younger patient with atrial fibrillation: an analysis of the RELY trial. Circulation 2011; 123: 2363-2372.
    CrossrefPubMedGoogle Scholar
  • 93 Wann LS, Curtis AB, Ellenbogen KA. et al. 2011 ACCF/AHA/HRS Focused Update on the Management of Patients With Atrial Fibrillation (Update on Dabigatran) A Report of the American College of Cardiology Foundation Foundation/ American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2011; 57: 1330-1337.
    CrossrefPubMedGoogle Scholar
  • 94 Ezekowitz MD, Reilly PA, Nehmiz G. et al. Dabigatran with or without concomitant aspirin compared with warfarin alone in patients with nonvalvular atrial fibrillation (PETRO Study). Am J Cardiol 2007; 100: 1419-1426.
    CrossrefPubMedGoogle Scholar
  • 95 Ahrens I, Lip GY, Peter K. New oral anticoagulant drugs in cardiovascular disease. Thromb Haemost 2010; 104: 49-60.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 96 Rivaroxaban-once daily, oral, direct factor Xa inhibition compared with vitamin K antagonism for prevention of stroke and Embolism Trial in Atrial Fibrillation: rationale and design of the ROCKET AF study. Am Heart J 2010; 159: 340-347 e1.
    CrossrefPubMedGoogle Scholar
  • 97 Alexander JH, Becker RC, Bhatt DL. et al. Apixaban, an oral, direct, selective factor Xa inhibitor, in combination with antiplatelet therapy after acute coronary syndrome: results of the Apixaban for Prevention of Acute Ischemic and Safety Events (APPRAISE) trial. Circulation 2009; 119: 2877-2885.
    CrossrefPubMedGoogle Scholar
  • 98 Connolly SJ, Eikelboom J, Joyner C. et al. Apixaban in patients with atrial fibrillation. New Engl J Med 2011; 364: 806-817.
    CrossrefPubMedGoogle Scholar
  • 99 Serruys PW, Ormiston JA, Onuma Y. et al. A bioabsorbable everolimus-eluting coronary stent system (ABSORB): 2-year outcomes and results from multiple imaging methods. Lancet 2009; 373: 897-910.
    CrossrefPubMedGoogle Scholar