Risks of Combining Dual Antiplatelet Therapy with Warfarin

Standard therapy for preventing stent thrombosis after PCI may be dangerous in patients taking long-term anticoagulants.

Current evidence supports dual antiplatelet therapy as the best strategy for preventing stent thrombosis and warfarin therapy as the best strategy for preventing thromboembolism. What happens when patients are at risk for both conditions? In this study, investigators in Italy tracked 127 patients discharged on dual antiplatelet therapy plus warfarin after percutaneous coronary intervention, to assess their risk for bleeding. Indications for warfarin included atrial fibrillation (59%), prosthetic valve (12%), LV thrombus (9%), and pulmonary embolism or deep venous thrombosis (8%). Warfarin was used indefinitely; antiplatelet therapy was continued for an average of 3.1 months after bare-metal stent implantation (in 44% of patients) and for an…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI

Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)