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European Heart Journal Advance Access originally published online on March 1, 2007
European Heart Journal 2007 28(6):657-658; doi:10.1093/eurheartj/ehl576
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© The European Society of Cardiology 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

The good, the bad, and the ugly: triple therapy after PCI in patients requiring chronic anticoagulation

Peter R. Sinnaeve*

Department of Cardiology, University of Leuven, Leuven, Belgium

* Corresponding author: Department of Cardiology, Gasthuisberg University Hospital, Herestraat 49, B-3000 Leuven, Belgium. Tel: +32 16 344235; fax: +32 16 344240. E-mail address: peter.sinnaeve@uz.kuleuven.ac.be

This editorial refers to ‘Safety and efficacy of combined antiplatelet-warfarin therapy after coronary stenting’{dagger} by P. Karjalainen et al., on page 726

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A percutaneous coronary intervention presents unique challenges to the antithrombotic management of patients requiring chronic anticoagulation. Warfarin is often discontinued several days before a percutaneous intervention, exposing patients to the risk of potentially life-threatening thrombo-embolic complications. In contrast, bridging the period after the intervention until a therapeutic INR is reached again often requires additional anticoagulation with heparin, greatly increasing the risk of in-hospital bleeding complications. One solution to this problem is to consider a transradial approach, which not only obviates the need for temporarily discontinuation of anticoagulation therapy, but also avoids having to administer additional heparin while restarting warfarin in patients already receiving dual antiplatelet therapy.1 Finding the ideal chronic antithrombotic combination after hospital discharge appears to be an even more challenging problem. Triple therapy, i.e. dual antiplatelet . . . [Full Text of this Article]


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Related articles in EHJ:

Safety and efficacy of combined antiplatelet-warfarin therapy after coronary stenting
Pasi P. Karjalainen, Pekka Porela, Antti Ylitalo, Saila Vikman, Kai Nyman, Mari-Anne Vaittinen, Tuukka J. Airaksinen, Matti Niemelä, Tero Vahlberg, and K.E. Juhani Airaksinen
EHJ 2007 28: 726-732. [Abstract] [Full Text]  



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