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Haemodynamic-guided management of heart failure (GUIDE-HF): a randomised controlled trial Poor Long-Term Survival in Patients With Moderate Aortic Stenosis Minimalist transcatheter aortic valve replacement: The new standard for surgeons and cardiologists using transfemoral access? Operator Experience and Outcomes After Left Main Percutaneous Coronary Intervention Bridging the Gap Between Epigenetic and Genetic in PAH Frailty and Bleeding in Older Adults Undergoing TAVR or SAVR: Insights From the FRAILTY-AVR Study Percutaneous Atriotomy for Levoatrial–to–Coronary Sinus Shunting in Symptomatic Heart Failure: First-in-Human Experience Aortic Valve Stenosis Treatment Disparities in the Underserved JACC Council Perspectives Serial intravascular ultrasound assessment of very late stent thrombosis after sirolimus-eluting stent placement Expert Recommendations on Cardiac Computed Tomography for Planning Transcatheter Left Atrial Appendage Occlusion

Review ArticleVolume 74, Issue 5, August 2019

JOURNAL:J Am Coll Cardiol. Article Link

Antithrombotics From Aspirin to DOACs in Coronary Artery Disease and Atrial Fibrillation (Part 3/5)

FWA Verheugt, JM ten Berg, RF Storey et al.

ABSTRACT

For secondary prevention of coronary artery disease (CAD), oral antiplatelet therapy is essential. In case of coronary intervention, temporary dual antiplatelet therapy is mandatory as well. Recently, low-dose oral anticoagulation has entered the CAD arena. Atrial fibrillation (AF) is often seen in CAD and vice versa. In most patients stroke prevention in AF consists of oral anticoagulation. In many cases of CAD in patients with AF, anticoagulation has to be combined with antiplatelet agents (so called, dual pathway antithrombotic therapy). Excess bleeding in these conditions is a rapidly rising problem. This review addresses the antithrombotic options in CAD alone, in AF alone, and in their combination, when either an invasive or a noninvasive approach has been chosen.