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Is oral anticoagulation needed in patients with atrial fibrillation and stent implantation at low–moderate risk of stroke?

Published:August 27, 2016DOI:https://doi.org/10.1016/j.ejim.2016.08.022
      Thromboprophylaxis for patients with coronary artery disease and atrial fibrillation (AF) is problematic when there is a low or moderate risk of stroke (CHADS2 score = 0 or 1), particularly when patients experience an acute coronary syndrome or undergo intracoronary stent implantation. Some physicians may be reluctant to prescribe oral anticoagulation (OAC) in these patients and several recent guidelines propose slightly different management in such settings [
      • Camm A.J.
      • Kirchhof P.
      • Lip G.Y.
      • Schotten U.
      • Savelieva I.
      • Ernst S.
      • et al.
      Guidelines for the management of atrial fibrillation: the Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC).
      ,
      • Lip G.Y.H.
      • Windecker S.
      • Huber K.
      • Kirchhof P.
      • Marin F.
      • Ten Berg J.M.
      • et al.
      Management of antithrombotic therapy in atrial fibrillation patients presenting with acute coronary syndrome and/or undergoing percutaneous coronary or valve interventions: a joint consensus document of the European Society of Cardiology Working Group on thrombosis, European Heart Rhythm Association (EHRA), European Association of Percutaneous Cardiovascular Interventions (EAPCI) and European Association of Acute Cardiac Care (ACCA) endorsed by the Heart Rhythm Society (HRS) and Asia-Pacific Heart Rhythm Society (APHRS).
      ]. Our goal was to evaluate whether treatment with an OAC is appreciably beneficial in these AF patients.

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