Antithrombotic treatment in atrial fibrillation patients undergoing percutaneous coronary interventions: focus on stent thrombosis

Coronary artery disease (CAD) commonly coexists with atrial fibrillation (AF), requiring oral anticoagulation (OAC) in a significant subset of patients. These patients also often require revascularization with percutaneous coronary intervention (PCI), which traditionally is supported with dual antiplatelet therapy (DAPT) to prevent complications including stent thrombosis (ST). Recent clinical studies have demonstrated that dual therapy (DAT, i.e. OAC plus single P2Y12 inhibitor) has a more favorable safety profile than triple antithrombotic therapy (TAT). As none of these trials were sufficiently powered for evaluating ischemic outcomes, some concerns remain regarding ischemic complications, in particular ST, a catastrophic complication of PCI.