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Double Antithrombotic Therapy Best for PCI Patients With AF

In patients with atrial fibrillation undergoing percutaneous coronary intervention (PCI) or with an acute coronary syndrome (ACS), an antithrombotic regimen of double therapy with a non-vitamin K antagonist oral anticoagulant (NOAC) plus a P2Y12 inhibitor antiplatelet agent such as clopidogrel (Plavix, Bristol-Myers Squibb) is the preferred treatment option, a new network meta-analysis suggests.

The analysis of four randomized trials comparing different combinations of anticoagulants and antiplatelet drugs found that the NOAC/P2Y12 inhibitor combination was associated with fewer bleeding complications — including intracranial hemorrhage — without a significant difference in ischemic events compared with regimens including a vitamin K antagonist anticoagulant (such as warfarin) and dual antiplatelet therapy (DAPT; aspirin plus a P2Y12 inhibitor).

The analysis was published online June 19 in JAMA Cardiology.

JAMA Cardiol. Published online June 19, 2019. Abstract