Anticoagulant and Antiplatelet Therapy in Patients with Atrial Fibrillation and Coronary Intervention

Several studies in 2016 and 2017 dealt with optimal treatment for patients who have both atrial fibrillation (AF) and coronary artery disease after percutaneous coronary intervention (PCI).

In one study, 2100 patients with nonvalvular AF who had undergone PCI were randomized to one of three groups:

• Rivaroxaban (15 mg daily) plus a P2Y₁₂ inhibitor, such as clopidogrel, for 12 months

• Lower-dose rivaroxaban (2.5 mg twice daily) plus dual antiplatelet therapy (DAPT) for 1, 6, or 12 months

• Warfarin plus DAPT for 1, 6, or 12 months

Patients who received DAPT for only 1 or 6 months then continued to receive aspirin monotherapy. At 1 year, clinically significant bleeding was lower in the rivaroxaban groups than in the warfarin-containing triple-therapy …