ANMCO position paper on antithrombotic treatment of patients with atrial fibrillation undergoing intracoronary stenting and/or acute coronary syndromes

Author:

De Luca Leonardo1ORCID,Rubboli Andrea2,Lettino Maddalena3,Tubaro Marco4,Leonardi Sergio5,Casella Gianni6,Valente Serafina7,Rossini Roberta8,Sciahbasi Alessandro9,Natale Enrico1,Trambaiolo Paolo9,Navazio Alessandro10,Cipriani Manlio11,Corda Marco12,De Nardo Alfredo13,Francese Giuseppina Maura14,Napoletano Cosimo15,Tizzani Emanuele16,Nardi Federico17,Roncon Loris18,Caldarola Pasquale19,Riccio Carmine20,Gabrielli Domenico1,Oliva Fabrizio11,Massimo Gulizia Michele21,Colivicchi Furio22

Affiliation:

1. Cardiology, Department of Cardio-Thoraco-Vascular, Azienda Ospedaliera San Camillo Forlanini, Circonvallazione Gianicolense, 87, 00152 Roma, Italy

2. Cardiology, Cardiovascular Department, Ospedale S. Maria delle Croci, Ravenna, Italy

3. Department of Cardiology, San Gerardo Hospital, ASST-Monza, Monza, Italy

4. CCU, Intensive and Interventional Cardiology Department, P.O. San Filippo Neri, Roma, Italy

5. University of Pavia and IRCCS S. Matteo Foundation General Hospital, Pavia, Italy

6. Cardiology Department, Ospedale Maggiore, Azienda USL di Bologna, Bologna, Italy

7. Cardio-Thoracic Department, A.O.U. Senese, Ospedale Santa Maria alle Scotte, Siena, Italy

8. Emergency Department and Critical Areas, Azienda Ospedaliera Santa Croce e Carle, Cuneo, Italy

9. Cardiology Department, Ospedale Sandro Pertini, ASL RM2, Roma, Italy

10. Hospital Cardiology Department, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy

11. Cardiology 2-Heart Failure and Transplants, Dipartimento Cardiotoracovascolare “A. De Gasperis”, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy

12. Cardiology Department, Azienda Ospedaliera G. Brotzu, Cagliari, Italy

13. Cardiology-ICU Department, Ospedale Civile “G. Jazzolino”, Vibo Valentia, Italy

14. Cardiology Department, Azienda di Rilievo Nazionale e Alta Specializzazione “Garibaldi”, Catania, Italy

15. Cardiology-ICU Department—Cath Lab, Presidio Ospedaliero “G. Mazzini”, Teramo, Italy

16. Cardiology Department, Ospedale degli Infermi, Rivoli, Italy

17. Cardiology Department, Ospedale Santo Spirito, Casale Monferrato (AL), Italy

18. Cardiology Department, Ospedale Santa Maria della Misericordia, Rovigo, Italy

19. Cardiology-ICU Department, Ospedale San Paolo, Bari, Italy

20. Follow-up of the Post-Acute Patient, Cardio-Vascular Department, AORN Sant'Anna and San Sebastiano, Caserta, Italy

21. Heart Care Foundation, Firenze, Italy

22. Clinical and Rehabilitation Cardiology Department, Presidio Ospedaliero San Filippo Neri, ASL Roma 1, Roma, Italy

Abstract

AbstractPatients with atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI) with or without acute coronary syndromes (ACS) represent a subgroup with a challenging pharmacological management. Indeed, if on the one hand, antithrombotic therapy should reduce the risk related to recurrent ischaemic events and/or stent thrombosis; on the other hand, care must be taken to avoid major bleeding events. In recent years, several trials, which overall included more than 12 000 patients, have been conducted demonstrating the safety of different therapeutic combinations of oral antiplatelet and anticoagulant agents. In the present ANMCO position paper, we propose a decision-making algorithm on antithrombotic strategies based on scientific evidence and expert consensus to be adopted in the periprocedural phase, at the time of hospital discharge, and in the long-term follow-up of patients with AF undergoing PCI with/without ACS.

Publisher

Oxford University Press (OUP)

Subject

Cardiology and Cardiovascular Medicine

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