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New-onset atrial fibrillation after percutaneous coronary intervention with stent: Updated proposal of an algorithm for the choice of oral anticoagulant and its dose

Published:January 10, 2017DOI:https://doi.org/10.1016/j.ejim.2017.01.003
      Whereas ongoing oral anticoagulation (OAC), with either warfarin or a non-vitamin K-antagonist oral anticoagulant (NOAC), should generally be confirmed in patients with atrial fibrillation (AF) who undergo percutaneous coronary intervention with stent (PCI-S) [
      • Di Minno G.
      • Russolillo A.
      • Gambacorta C.
      • Di Minno A.
      • Prisco D.
      Improving the use of direct oral anticoagulants in atrial fibrillation.
      ,
      • Rubboli A.
      • Faxon D.P.
      • Airaksinen K.E.
      • Schlitt A.
      • Marìn F.
      • Bhatt D.L.
      • et al.
      The optimal management of patients on oral anticoagulation undergoing coronary artery stenting. The 10th anniversary overview.
      ], the type (i.e., warfarin versus NOAC) and dose (i.e., standard versus reduced) of the oral anticoagulant to be added to dual anti platelet therapy of aspirin and clopidogrel (DAPT) when AF develops early after PCI-S need necessarily to be chosen.
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      References

        • Di Minno G.
        • Russolillo A.
        • Gambacorta C.
        • Di Minno A.
        • Prisco D.
        Improving the use of direct oral anticoagulants in atrial fibrillation.
        Eur J Intern Med. 2013; 24: 288-294
        • Rubboli A.
        • Faxon D.P.
        • Airaksinen K.E.
        • Schlitt A.
        • Marìn F.
        • Bhatt D.L.
        • et al.
        The optimal management of patients on oral anticoagulation undergoing coronary artery stenting. The 10th anniversary overview.
        Thromb Haemost. 2014; 112: 1080-1087
        • Rubboli A.
        • Agewall S.
        • Huber K.
        • Lip G.Y.
        New-onset atrial fibrillation after recent coronary stenting: warfarin or non-vitamin K-antagonist oral anticoagulant to be added to aspirin and clopidogrel? A viewpoint.
        Int J Cardiol. 2015; 96: 133-138
        • Rubboli A.
        • Verheugt F.W.A.
        Reduced dose and reduced exposure to non-vitamin K-antagonist oral anticoagulants: some considerations on this relationship.
        Int J Cardiol. 2016; 223: 519-520
        • Ruff C.T.
        • Giugliano R.P.
        • Braunwald E.
        • Hoffman E.B.
        • Deenadayalu N.
        • Ezekowitz M.D.
        • et al.
        Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials.
        Lancet. 2014; 383: 955-962
        • Kubitza D.
        • Becka M.
        • Mueck W.
        • Halabi A.
        • Maatouk H.
        • Klause N.
        • et al.
        Effects of renal impairment on the pharmacokinetics, pharmacodynamics and safety of rivaroxaban, an oral, direct factor Xa inhibitor.
        Br J Clin Pharmacol. 2010; 70: 703-712
        • Active Writing Group for the ACTIVE Investigators
        Clopidogrel plus aspirin versus oral anticoagulation for atrial fibrillation in the Atrial fibrillation Clopidogrel Trial with Irbesartan for prevention of Vascular Events (ACTIVE W): a randomized controlled trial.
        Lancet. 2006; 367: 1903-1912
        • Reilly P.A.
        • Lehr T.
        • Haertter S.
        • Connolly S.J.
        • Yusuf S.
        • Eikelboom J.W.
        • et al.
        The effect of dabigatran plasma concentrations and patient characteristics on the frequency of ischemic stroke and major bleeding in atrial fibrillation patients. The RE-LY trial (Randomized Evaluation of Long-term anticoagulation therapy).
        J Am Coll Cardiol. 2014; 63: 321-328
        • Ruff C.T.
        • Giugliano R.P.
        • Braunwald E.
        • Morrow D.A.
        • Murphy S.A.
        • Kuder J.F.
        • et al.
        Association between edoxaban dose, concentration, anti-factor Xa activity, and outcomes: an analysis of data from the randomised, double-blind ENGAGE AF-TIMI 48 trial.
        Lancet. 2015; 385: 2288-2295
        • Giugliano R.P.
        • Ruff C.T.
        • Braunwald E.
        • Murphy S.A.
        • Wiviott S.D.
        • Halperin J.L.
        • et al.
        ENGAGE AF-TIMI 48 investigators, edoxaban versus warfarin in patients with atrial fibrillation.
        N Engl J Med. 2013; 369: 2093-2104