Triple therapy with dual antiplatelet treatment and direct oral anticoagulants

Published: 11 July 2017
Author(s): Marc Sorigue, Edurne Sarrate, Javier Delcastillo
Issue: July 2017
Section: Letter to the Editor

In their recent review, Dezsi et al. [1] summarize the evidence on antithrombotic treatment in patients with atrial fibrillation (AF) who have undergone percutaneous coronary intervention (PCI) with stenting, arguably the most common clinical situation requiring triple therapy (dual antiplatelet [DAPT] and anticoagulant treatment). This topic is of renewed relevance since the introduction of direct oral anticoagulants (DOACs), which are now commonly employed for stroke prevention in AF. Their use as part of triple therapy is less well-established due to both a lack of evidence in this setting as well as evidence of increased bleeding with limited benefit in patients with acute coronary syndrome [2,3].