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Increasingly, patients are receiving antiplatelet agents plus warfarin when indications exist for both (e.g., atrial fibrillation and coronary stenting). In two studies, researchers examined bleeding complications in such patients.
Italian researchers followed 127 consecutive patients who underwent percutaneous coronary intervention with stenting (resulting in treatment with aspirin plus a thienopyridine [clopidogrel or ticlopidine]) and who also were receiving warfarin (e.g., for atrial fibrillation or prosthetic heart valves). During an average of 6 months on triple therapy (2 antiplatelet drugs plus warfarin), six patients experienced major bleeding complications, which resulted in three deaths related to intracranial bleeding.
In a study …