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April 09, 2021
Dropping aspirin soon after PCI seems to be the best strategy for preventing bleeding in high-risk patients with nonvalvular atrial fibrillation (AF), according to a landmark analysis of the RE-DUAL PCI trial.
As reported by TCTMD, RE-DUAL PCI supported moving away from a triple-therapy strategy P2Y12 inhibitor, warfarin, and aspirin in these patients in order to lessen bleeding without increasing the risk of thrombotic events.
The new data in conjunction with the rest of the available evidence, including those from AUGUSTUS, “are pretty clear that that strategy of prolonged triple therapy almost should never be used,” study co-author Deepak L. Bhatt, MD, MPH (Brigham and Women’s Hospital, Boston, MA), told TCTMD. “Our article sort of helps bring some granularity to the sort of minimum duration of aspirin that s probably needed.”
New-yorkUnited-statesItalyBostonMassachusettsBenjamine-petersonDeepakl-bhattRoxana-mehranDavide-capodannoPhd-university-of-cataniaIcahn-schoolMount-sinaiApril 06, 2021
For patients sent for an unplanned PCI, a strategy of maintaining oral anticoagulation is not associated with a higher risk of ischemic complications or bleeding when compared with a strategy of interrupting the direct oral anticoagulant (DOAC) or vitamin K antagonist (VKA) a day or two before the procedure, a new observational analysis confirms.
Published in the April 12, 2021, issue of
JACC: Cardiovascular Interventions, the study, drawing on the large SWEDEHEART registry, supports the current recommendations from the European Society of Cardiology (ESC) for uninterrupted oral anticoagulation (U-OAC) in patients with atrial fibrillation, venous thromboembolism, or a mechanical heart valve undergoing unplanned, nonemergent PCI, investigators say.
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