Triple Antithrombotic Therapy vs. Double Antithrombotic Therapy: One Scenario, 8 Questions, Many Conclusions

摘要

In patients with atrial fibrillation undergoing percutaneous coronary intervention with theplacement of stents, a triple antithrombotic therapy is empirically established, which consists of acombination of dual antithrombotic therapy (aspirin plus a P2Y12 inhibitor) and an oral anticoagulantagent. This choice is guided by the desirable result of reducing cerebrovascular and coronaryischemic events. However, there is an unwelcome outcome: an increased incidence of bleeding. Onthis matter, in 2018, a North American Perspective Update was published, about a year later it wasfollowed by the publication of the European focus update on the dual antiplatelet therapy. Afteranalysing the main differences between these two consensus documents, this review aims at examiningthe major studies on which they are based on, as a starting point to define the foundation ofnew trials that can help shed light on this prominent topic.