Atrial Fibrillation Patients’ Experiences with Combination Antithrombotic Therapy Post-Percutaneous Coronary Intervention

BackgroundUp to 30% of patients with atrial fibrillation (AF) have coronary artery disease (CAD) and many undergo percutaneous intervention (PCI). In the setting acute syndrome (ACS) PCI, or high-risk elective Canadian AF guidelines recommend 1-30 days acetylsalicylic acid (ASA), 1-12 months clopidogrel, oral anticoagulation (OAC) doses that may change throughout 12-months post-PCI. The complexity these regimens contribute unplanned modifications (UPMs), increasing risk thrombosis and/or bleeding. We describe what happens their antithrombotic therapy (ATT) after discharge.MethodsProspective follow-up requiring OAC who underwent PCI were discharged on combination ATT. Patients contacted at 1-, 3-, 6-, post-PCI.ResultsSixty-five enrolled data any time point available for 61 (94%). Of these, 44 (68%) experienced least one UPM total, 105 UPMs occurred. most common was extended duration P2Y12 inhibitor (23, 22%). ASA (11, 11%) shortened duration. Thirty-nine (37%) related OACs; 9 (23%) warfarin 30 (77%) DOACs. all UPM, 33 (75%) bleeding.ConclusionMore than 2 in 3 undergoing an modification This underscores challenges ATT clinicians alike, emphasizing need patient support discharge.