Bleeding Risks with Triple Antithrombotic Therapy, Quantified

Compared with an anticoagulant plus antiplatelet monotherapy, triple antithrombotic therapy increased bleeding risk by ≈40% without reducing risk for thrombotic events.

Patients with both atrial fibrillation (AF) and acute coronary syndromes pose a difficult and frequent clinical conundrum: how to address the need for both anticoagulation and dual antiplatelet therapy without increasing bleeding risk. In this Danish study, investigators used national patient registries of all hospital admissions and prescriptions to study outcomes in 11,480 patients with AF who were hospitalized for myocardial infarction (MI) or percutaneous coronary intervention during a 9-year period.

At baseline, mean patient age was 76, and 61% were men. Patients received various combinations of aspirin, clopidogrel, and vitamin K antagonists (VKAs). At 1 year, the crude incidence rate of fatal or nonfatal bleeding per 100 person-years …

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)