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Canadian Journal of Cardiology

Warfarin Monotherapy in Atrial Fibrillation Patients With Stable Coronary Disease One Year After Myocardial Infarction/Stent: Two Birds With One Stone?

  • Annie Y. Chou
    Affiliations
    Division of Cardiology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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  • G.B. John Mancini
    Correspondence
    Corresponding author: Dr G.B. John Mancini, 2775 Laurel St, Level 9 Vancouver General Hospital, Vancouver, British Columbia V5Z1M9, Canada. Tel.: +604-875-4453.
    Affiliations
    Division of Cardiology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada
    Search for articles by this author
Published:March 11, 2015DOI:https://doi.org/10.1016/j.cjca.2015.03.007

      Abstract

      Patients with atrial fibrillation and stable coronary artery disease remain a therapeutic challenge because of the different antithrombotic therapies for the 2 conditions and the increase in bleeding with concomitant antiplatelet and anticoagulant medications. Current guidelines extrapolated data from studies of antithrombotic regimens of each condition separately but there is limited evidence for the optimal regimen in patients with atrial fibrillation and stable coronary artery disease beyond the first year after an acute coronary syndrome or stent implantation. In this review we suggest that warfarin monotherapy is sufficient for this patient population beyond 1 year.

      Résumé

      Les patients souffrant de fibrillation auriculaire et de coronaropathie stable représentent encore un défi thérapeutique en raison des différentes thérapies antithrombotiques de ces 2 affections et de l’augmentation des hémorragies liées à la prise concomitante de médicaments antiplaquettaires et anticoagulants. Les lignes directrices actuelles extrapolent les données des études sur les régimes posologiques antithrombotiques de chacune des affections. Cependant, il existe peu de données probantes sur le régime posologique optimal des patients souffrant de fibrillation auriculaire et de coronaropathie stable au-delà de la première année après un syndrome coronarien aigu ou l’implantation d’une endoprothèse. Dans cette revue, nous suggérons que la warfarine en monothérapie est suffisante chez cette population de patients au-delà de 1 an.
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