Antithrombotic therapy in patients with atrial fibrillation after percutaneous coronary interventions
https://doi.org/10.17802/2306-1278-2022-11-1-98-106
Abstract
Highlights. The article analyzes the current evidence base for anticoagulant and antiplatelet therapy in patients with atrial fibrillation undergoing percutaneous coronary interventions, and future perspectives of such therapy.
Abstract. A number of patients undergoing percutaneous coronary intervention may require intensification of antithrombotic therapy. These include patients with atrial fibrillation. The difficulty of treatment of this group of patients consists in the achievement of a certain level of hypocoagulation, which will be sufficient for the prevention of acute ischemic events, mainly associated with the implanted coronary stent, but will not lead to the clinically relevant bleeding. Achieving this balance requires a careful and personalized approach to prescribing a variety of combination (antiplatelet and anticoagulant) therapy regimens. The article provides an overview of modern antithrombotic therapy regimens in this group of patients, their evidence base and promising directions for improving such therapy.
About the Authors
O. V. Krestyaninov
Meshalkin National Medical Research Center of the Ministry of Health of Russian Federation
Russian Federation
Competing Interests:
Russian Federation
Oleg V. Krestyaninov - PhD, Head of the Department of Endovascular Surgery, Federal State Budgetary Institution “Meshalkin National Medical Research Center” of the Ministry of Health of Russian Federation.
15, Rechkunovskaya St., Novosibirsk, 630055.
Competing Interests:
No
A. G. Badoian
Meshalkin National Medical Research Center of the Ministry of Health of Russian Federation
Russian Federation
Competing Interests:
Russian Federation
Aram G. Badoian - Specialist in X-Ray Endovascular Diagnostics and Treatment at the Endovascular Surgery Center, Federal State Budgetary Institution “Meshalkin National Medical Research Center” of the Ministry of Health of Russian Federation.
15, Rechkunovskaya St., Novosibirsk, 630055.
Competing Interests:
No
R. A. Naydenov
Meshalkin National Medical Research Center of the Ministry of Health of Russian Federation
Russian Federation
Competing Interests:
Russian Federation
Roman A. Naydenov - PhD, Head of the Department of X-ray Surgical Diagnostics and Treatment, Federal State Budgetary Institution “Meshalkin National Medical Research Center” of the Ministry of Health of Russian Federation.
15, Rechkunovskaya St., Novosibirsk, 630055.
Competing Interests:
No
V. I. Baystrukov
Meshalkin National Medical Research Center of the Ministry of Health of Russian Federation
Russian Federation
Competing Interests:
Russian Federation
Vitaly I. Baistrukov - Specialist in X-ray Endovascular Diagnostics and Treatment at the Endovascular Surgery Center, Federal State Budgetary Institution “Meshalkin National Medical Research Center” of the Ministry of Health of Russian Federation.
15, Rechkunovskaya St., Novosibirsk, 630055.
Competing Interests:
Нет
References
1. Heeringa J., van der Kuip D.A., Hofman A., Kors J.A., van Herpen G., Stricker B.H., Stijnen T., Lip G.Y., Witteman J.C. Prevalence, incidence and lifetime risk of atrial fibrillation: the Rotterdam study. Eur Heart J. 2006;27(8):949-53. doi: 10.1093/eurheartj/ehi825
2. Lloyd-Jones D.M., Wang T.J., Leip E.P., Larson M.G., Levy D., Vasan R.S., D'Agostino R.B., Massaro J.M., Beiser A., Wolf P.A., Benjamin E.J. Lifetime risk for development of atrial fibrillation: the Framingham Heart Study. Circulation. 2004;110(9):1042-6. doi: 10.1161/01.CIR.0000140263.20897.42
3. Ohsawa M., Okayama A., Sakata K., Kato K., Itai K., Onoda T., Ueshima H. Rapid increase in estimated number of persons with atrial fibrillation in Japan: an analysis from national surveys on cardiovascular diseases in 1980, 1990 and 2000. J Epidemiol. 2005 Sep;15(5):194-6. doi: 10.2188/jea.15.194
4. Roskell N.S., Samuel M., Noack H., Monz B.U. Major bleeding in patients with atrial fibrillation receiving vitamin K antagonists: a systematic review of randomized and observational studies. Europace. 2013;15(6):787-797. doi:10.1093/europace/eut001
5. Shoeb M., Fang M.C. Assessing bleeding risk in patients taking anticoagulants. J Thromb Thrombolysis. 2013;35(3):312-319. doi:10.1007/s11239-013-0899-7
6. ACTIVE Writing Group of the ACTIVE Investigators; Connolly S., Pogue J., Hart R., Pfeffer M., Hohnloser S., Chrolavicius S., Pfeffer M., Hohnloser S., Yusuf S. 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 randomised controlled trial. Lancet. 2006;367(9526):1903-12. doi: 10.1016/S0140-6736(06)68845-4
7. Lip G.Y.H., Collet J.P., Haude M., Byrne R., Chung E.H., Fauchier L., Halvorsen S., Lau D., Lopez-Cabanillas N., Lettino M., Marin F., Obel I., Rubboli A., Storey R.F., Valgimigli M., Huber K.; ESC Scientific Document Group. 2018 Joint European consensus document on the management of antithrombotic therapy in atrial fibrillation patients presenting with acute coronary syndrome and/or undergoing percutaneous cardiovascular interventions: a joint consensus document of the European Heart Rhythm Association (EHRA), European Society of Cardiology Working Group on Thrombosis, European Association of Percutaneous Cardiovascular Interventions (EAPCI), and European Association of Acute Cardiac Care (ACCA) endorsed by the Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), Latin America Heart Rhythm Society (LAHRS), and Cardiac Arrhythmia Society of Southern Africa (CASSA). Europace. 2019;21(2):192-193. doi: 10.1093/europace/euy174
8. Yamashita Y., Uozumi R., Hamatani Y., Esato M., Chun Y.H., Tsuji H., Wada H., Hasegawa K., Ogawa H., Abe M., Morita S., Akao M. Current Status and Outcomes of Direct Oral Anticoagulant Use in Real-World Atrial Fibrillation Patients -Fushimi AF Registry. Circ J. 2017 Aug 25;81(9):1278-1285. doi: 10.1253/circj.CJ-16-1337
9. Kirchhof P., Ammentorp B., Darius H., De Caterina R., Le Heuzey J.Y., Schilling R.J., Schmitt J., Zamorano J.L. Management of atrial fibrillation in seven European countries after the publication of the 2010 ESC Guidelines on atrial fibrillation: primary results of the PREvention oF thromboemolic events--European Registry in Atrial Fibrillation (PREFER in AF). Europace. 2014;16(1):6-14. doi: 10.1093/europace/eut263
10. Goto S., Bhatt D.L., Rother J., Alberts M., Hill M.D., Ikeda Y., Uchiyama S., D'Agostino R., Ohman E.M., Liau C.S., Hirsch A.T., Mas J.L., Wilson P.W., Corbalan R., Aichner F., Steg P.G.; REACH Registry Investigators. Prevalence, clinical profile, and cardiovascular outcomes of atrial fibrillation patients with atherothrombosis. Am Heart J. 2008;156(5):855-63, 863.e2. doi: 10.1016/j.ahj.2008.06.029
11. Hansen M.L., S0rensen R., Clausen M.T., Fog-Petersen M.L., Rauns0 J., Gadsb0ll N., Gislason G.H., Folke F., Andersen S.S., Schramm T.K., Abildstrom S.Z., Poulsen H.E., K0ber L., Torp-Pedersen C. Risk of bleeding with single, dual, or triple therapy with warfarin, aspirin, and clopidogrel in patients with atrial fibrillation. Arch Intern Med. 2010;170(16):1433-41. doi: 10.1001/archinternmed.2010.271
12. S0rensen R., Hansen M.L., Abildstrom S.Z., Hvelplund A., Andersson C., J0rgensen C., Madsen J.K., Hansen P.R., K0ber L., Torp-Pedersen C., Gislason G.H. Risk of bleeding in patients with acute myocardial infarction treated with different combinations of aspirin, clopidogrel, and vitamin K antagonists in Denmark: a retrospective analysis of nationwide registry data. Lancet. 2009;374(9706):1967-74. doi: 10.1016/S0140-6736(09)61751-7
13. Dahal K., Mustafa U., Sharma S.P., Apte N., Bogabathina H., Hanna M., Watti H., Azrin M., Lee J., Mina G., Katikaneni P., Modi K. Ischemic and bleeding outcomes of triple therapy in patients on chronic anticoagulation undergoing percutaneous coronary intervention: A meta-analysis of randomized trials. JRSM Cardiovasc Dis. 2019;8:2048004019885572. doi:10.1177/2048004019885572
14. Ibanez B., James S., Agewall S., Antunes M.J., Bucciarelli-Ducci C., Bueno H., Caforio A.L.P., Crea F., Goudevenos J.A., Halvorsen S., Hindricks G., Kastrati A., Lenzen M.J., Prescott E., Roffi M., Valgimigli M., Varenhorst C., Vranckx P., Widimsky P.; ESC Scientific Document Group. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J. 2018;39(2):119-177. doi: 10.1093/eurheartj/ehx393
15. Dewilde W.J., Oirbans T., Verheugt F.W., Kelder J.C., De Smet B.J., Herrman J.P., Adriaenssens T., Vrolix M., Heestermans A.A., Vis M.M., Tijsen J.G., van 't Hof A.W., ten Berg J.M.; WOEST study investigators. Use of clopidogrel with or without aspirin in patients taking oral anticoagulant therapy and undergoing percutaneous coronary intervention: an open-label, randomised, controlled trial. Lancet. 2013;381(9872):1107-15. doi: 10.1016/S0140-6736(12)62177-1
16. Dans A.L., Connolly S.J., Wallentin L., Yang S., Nakamya J., Brueckmann M., Ezekowitz M., Oldgren J., Eikelboom J.W., Reilly P.A., Yusuf S. Concomitant use of antiplatelet therapy with dabigatran or warfarin in the Randomized Evaluation of Long-Term Anticoagulation Therapy (RE-LY) trial. Circulation. 2013;127(5):634-40. doi: 10.1161/CIRCULATIONAHA.112.115386
17. Xu H., Ruff C.T., Giugliano R.P., Murphy S.A., Nordio F., Patel I., Shi M., Mercuri M., Antman E.M., Braunwald E. Concomitant Use of Single Antiplatelet Therapy With Edoxaban or Warfarin in Patients With Atrial Fibrillation: Analysis From the ENGAGE AF-TIMI48 Trial. J Am Heart Assoc. 2016;5(2):e002587. doi: 10.1161/JAHA.115.002587
18. Sindet-Pedersen C., Lamberts M., Staerk L., Nissen Bonde A., Berger J.S., Pallisgaard J.L., Lock Hansen M., Torp-Pedersen C., Gislason G.H., Olesen J.B. Combining Oral Anticoagulants With Platelet Inhibitors in Patients With Atrial Fibrillation and Coronary Disease. J Am Coll Cardiol. 2018;72(15):1790-1800. doi: 10.1016/j.jacc.2018.07.054
19. Gibson C.M., Mehran R., Bode C., Halperin J., Verheugt F., Wildgoose P., van Eickels M., Lip G.Y., Cohen M., Husted S., Peterson E., Fox K. An open-label, randomized, controlled, multicenter study exploring two treatment strategies of rivaroxaban and a dose-adjusted oral vitamin K antagonist treatment strategy in subjects with atrial fibrillation who undergo percutaneous coronary intervention (PIONEER AF-PCI). Am Heart J. 2015;169(4):472-8.e5. doi: 10.1016/j.ahj.2014.12.006.
20. Cannon C.P., Bhatt D.L., Oldgren J., Lip G.Y.H., Ellis S.G., Kimura T., Maeng M., Merkely B., Zeymer U., Gropper S., Nordaby M., Kleine E., Harper R., Manassie J., Januzzi J.L., Ten Berg J.M., Steg P.G., Hohnloser S.H.; RE-DUAL PCI Steering Committee and Investigators. Dual Antithrombotic Therapy with Dabigatran after PCI in Atrial Fibrillation. N Engl J Med. 2017;377(16):1513-1524. doi: 10.1056/NEJMoa1708454
21. Lopes R.D., Heizer G., Aronson R., Vora A.N., Massaro T., Mehran R., Goodman S.G., Windecker S., Darius H., Li J., Averkov O., Bahit M.C., Berwanger O., Budaj A., Hijazi Z., Parkhomenko A., Sinnaeve P., Storey R.F., Thiele H., Vinereanu D., Granger C.B., Alexander J.H.; AUGUSTUS Investigators. Antithrombotic Therapy after Acute Coronary Syndrome or PCI in Atrial Fibrillation. N Engl J Med. 2019;380(16):1509-1524. doi: 10.1056/NEJMoa1817083
22. Vranckx P., Valgimigli M., Eckardt L., Tijssen J., Lewalter T., Gargiulo G., Batushkin V., Campo G., Lysak Z., Vakaliuk I., Milewski K., Laeis P., Reimitz P.E., Smolnik R., Zierhut W., Goette A. Edoxaban-based versus vitamin K antagonist-based antithrombotic regimen after successful coronary stenting in patients with atrial fibrillation (ENTRUST-AF PCI): a randomised, open-label, phase 3b trial. Lancet. 2019;394(10206):1335-1343. doi: 10.1016/S0140-6736(19)31872-0
23. Hindricks G., Potpara T., Dagres N., Arbelo E., Bax J.J., Blomstrom-Lundqvist C., Boriani G., Castella M., Dan G.A., Dilaveris P.E., Fauchier L., Filippatos G., Kalman J.M., La Meir M., Lane D.A., Lebeau J.P., Lettino M., Lip G.Y.H., Pinto F.J., Thomas G.N., Valgimigli M., Van Gelder I.C., Van Putte B.P., Watkins C.L.; ESC Scientific Document Group. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC. Eur Heart J. 2021;42(5):373-498. doi: 10.1093/eurheartj/ehaa612
24. Angiolillo D.J., Bhatt D.L., Cannon C.P., Eikelboom J.W., Gibson C.M., Goodman S.G., Granger C.B., Holmes D.R., Lopes R.D., Mehran R., Moliterno D.J., Price M.J., Saw J., Tanguay J.F., Faxon D.P. Antithrombotic Therapy in Patients With Atrial Fibrillation Treated With Oral Anticoagulation Undergoing Percutaneous Coronary Intervention: A North American Perspective: 2021 Update. Circulation. 2021;143(6):583-596. doi: 10.1161/CIRCULATIONAHA.120.050438
25. Kumbhani D.J., Cannon C.P., Beavers C.J., Bhatt D.L., Cuker A., Gluckman T.J., Marine J.E., Mehran R., Messe S.R., Patel N.S., Peterson B.E., Rosenfield K., Spinler S.A., Thourani V.H. 2020 ACC Expert Consensus Decision Pathway for Anticoagulant and Antiplatelet Therapy in Patients With Atrial Fibrillation or Venous Thromboembolism Undergoing Percutaneous Coronary Intervention or With Atherosclerotic Cardiovascular Disease: A Report of the American College of Cardiology Solution Set Oversight Committee. J Am Coll Cardiol. 2021;77(5):629-658. doi: 10.1016/j.jacc.2020.09.011
26. January C.T., Wann L.S.,Alpert J.S., Calkins H., Cigarroa J.E., Cleveland J.C. Jr., Conti J.B., Ellinor P.T., Ezekowitz M.D., Field M.E., Murray K.T., Sacco R.L., Stevenson W.G., Tchou P.J., Tracy C.M., Yancy C.W.; ACC/AHA Task Force Members. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and the Heart Rhythm Society. Circulation. 2014;130(23):2071-104. doi: 10.1161/CIR.0000000000000040
27. Yasuda S., Kaikita K., Akao M., Ako J., Matoba T., Nakamura M., Miyauchi K., Hagiwara N., Kimura K., Hirayama A., Matsui K., Ogawa H.; AFIRE Investigators. Antithrombotic Therapy for Atrial Fibrillation with Stable Coronary Disease. N Engl J Med. 2019;381(12):1103-1113. doi: 10.1056/NEJMoa1904143
28. Kirolos I., Ifedili I., Maturana M., Premji A.M., Cave B., Roman S., Jones D., Gaid R., Levine Y.C., Jha S., Kabra R., Khouzam R.N. Ticagrelor or prasugrel vs. clopidogrel in combination with anticoagulation for treatment of acute coronary syndrome in patients with atrial fibrillation. Ann Transl Med. 2019;7(17):406. doi: 10.21037/atm.2019.07.41
29. Weitz J., Fredenburgh J.C. Factors XI and XII as Targets for New Anticoagulants. Front Med (Lausanne). 2017;4:19. doi: 10.3389/fmed.2017.00019
Review
For citations:
Krestyaninov O.V., Badoian A.G., Naydenov R.A., Baystrukov V.I. Antithrombotic therapy in patients with atrial fibrillation after percutaneous coronary interventions. Complex Issues of Cardiovascular Diseases. 2022;11(1):98-106. (In Russ.) https://doi.org/10.17802/2306-1278-2022-11-1-98-106
Views:
479
