Atrial Fibrillation and Percutaneous Coronary Intervention A Case-ba
This book considers paradigmatic clinical cases in order to cast light on key issues relating to elective or emergency stent implantation and the use of oral anticoagulation (OAC) in patients with atrial fibrillation. The topics addressed include the opti
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Atrial Fibrillation and Percutaneous Coronary Intervention
Andrea Rubboli • Gregory Y.H. Lip Editors
Atrial Fibrillation and Percutaneous Coronary Intervention A Case-based Guide to Oral Anticoagulation, Antiplatelet Therapy and Stenting
Editors Andrea Rubboli Division of Cardiology Laboratory of Interventional Cardiology Ospedale Maggiore Bologna Italy
Gregory Y.H. Lip Centre for Cardiovascular Sciences University of Birmingham City Hospital Birmingham UK
ISBN 978-3-319-42398-2 ISBN 978-3-319-42400-2 DOI 10.1007/978-3-319-42400-2
(eBook)
Library of Congress Control Number: 2016958439 © Springer International Publishing Switzerland 2017 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. Printed on acid-free paper This Springer imprint is published by Springer Nature The registered company is Springer International Publishing AG Switzerland The registered company address is Gewerbestrasse 11, 6330 Cham, Switzerland
Preface
Atrial fibrillation (AF) is nowadays an “epidemic disease” and is associated to an increased risk of ischemic stroke. Because of that, oral anticoagulation with nonvitamin K-antagonist oral anticoagulants (NOACs, including dabigatran, rivaroxaban, apixaban and edoxaban), or vitamin K antagonists (e.g. warfarin) is warranted in the majority of cases. The recognition that AF is often associated to coronary artery disease, for which percutaneous coronary intervention with stent implantation (PCI) has become the standard of care, makes the issue of antithrombotic treatment complex as well as of great epidemiological relevance. While oral anticoagulation is the optimal therapy for stroke prevention in AF, dual antiplatelet therapy with aspirin and a P2Y12-receptor inhibitor, including clopidogrel, prasugrel, or ticagrelor, is the most effective treatment for the prevention of stent thrombosis and/or recurrent cardiac events after PCI. No randomized, double-blind, prospective studies comparing different antithrombotic strategies in these patients a
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