Jiaoyan Tan1,
Liangyi Si1,
Xiaorong Yang2,
Jia Yue1 
For correspondence:- Jia Yue Email: 251553821@qq.com
Accepted: 16 November Published: 29 December 2022
Citation: Tan J, Si L, Yang X, Yue J. Dual and triple antithrombotic pharmacotherapy in patients with coronary heart disease complicated with atrial fibrillation after percutaneous coronary intervention. Trop J Pharm Res 2022; 21(12):2693-2700 doi: 10.4314/tjpr.v21i12.26
© 2022 The authors.
This is an Open Access article that uses a funding model which does not charge readers or their institutions for access and distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0) and the Budapest Open Access Initiative (http://www.budapestopenaccessinitiative.org/read), which permit unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited..
Purpose: To compare the influence of triple antithrombotic therapy (warfarin + aspirin + clopidogrel) and dual antithrombotic therapy (aspirin + clopidogrel) on the risk of major adverse cardiovascular and cerebrovascular events (MACCEs) in patients with atrial fibrillation (AF) after coronary stent implantation.
Methods: A total of 210 patients with coronary heart disease and complicated with AF, who underwent percutaneous coronary intervention (PCI) in The Third Affiliated Hospital of Chongqing Medical University, were enrolled. They were divided into a triple antithrombotic therapy group (TT group) and a dual antithrombotic therapy group (DT group). The risks of hemorrhage and MACCEs were evaluated via follow-up and multivariate regression analysis.
Results: Based on the classification criteria for bleeding in Thrombolysis in Myocardial Infarction (TIMI) and Global Use of Strategies to Open Occluded Coronary Arteries (GUSTO), there were 6 and 0 patients with significant hemorrhage in TT and DT groups, respectively, during the one year of follow-up (p = 0.013). The total number of MACCEs of 52 and 61 for both groups was not significantly different (p = 0.213). Moreover, the results of multivariate Cox regression analysis revealed that the histories of ischemia and stroke (p = 0.023), heart failure (p = 0.007), and high CHA2DS2-VASc score (p = 0.004) were the risk factors for MACCEs.
Conclusion: Compared with dual antithrombotic therapy, triple antithrombotic therapy increases the risk of major hemorrhage in AF patients after PCI, but does not noticeably reduce the incidence of MACCEs during one year of follow-up.
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