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Combining antiplatelet and anticoagulant therapies
JACC - Journal of the American College of Cardiology, 07/02/09

Holmes DR et al. – A JACC white paper reports that it is both prudent and timely to review treatment strategies using combinations of antiplatelet and anticoagulant therapies as well as strategies aimed at reducing bleeding risk in pts treated with these therapies.

• Review focusing on combining antiplatelet and anticoagulant therapies

• Antiplatelet therapy: cornerstone for both primary and secondary prevention therapies for ischemic events resulting from coronary atherosclerotic disease
• Dual antiplatelet therapy (aspirin + a thienopyridine, usually clopidogrel): central role in treatment of acute coronary syndromes and after coronary stent deployment
• In addition to antiplatelet therapy, anticoagulant therapy may be indicated for stroke prevention for atrial fibrillation, profound left ventricular dysfunction, and after mechanical prosthetic heart valve replacement
• Use of triple antithrombotic therapy (dual antiplatelet regimen + warfarin) may increase due to an aging pt population
• Triple therapy: may prevent both thromboembolism and stent thrombosis; associated with significant bleeding hazards

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