Rapid Review Afib: The Latest in Management Strategies - Clinical Spotlight Meeting on Demand-Triple Therapy: When to Use and How Long

Video Transcription

Video Summary

Dr. Dharam Kumbhani discussed the use of triple therapy, which combines anticoagulant, antiplatelet, and aspirin therapy, for patients with atrial fibrillation (A-fib) who have also undergone percutaneous coronary intervention (PCI). Multiple studies have shown that the combination of anticoagulation and dual antiplatelet therapy is associated with a higher risk of bleeding. However, recent trials have demonstrated that dual therapy with a oral anticoagulant and a P2Y12 inhibitor, such as clopidogrel, is associated with reduced bleeding risk compared to triple therapy. There is also no significant difference in ischemic endpoints or stent thrombosis between dual and triple therapy. The use of aspirin in this treatment regimen remains controversial, with some studies showing no benefits in ischemic outcomes. Clopidogrel is the preferred P2Y12 inhibitor in dual therapy regimens. There may be a potential benefit of low-dose aspirin for patients with high stent thrombosis risk and low bleeding risk.

Keywords

triple therapy

anticoagulant

antiplatelet

aspirin therapy

A-fib