![]() ![]() ![]() Moreover, in patients at low ischemic risk as well as those at high risk for bleeding, it is reasonable to discontinue the SAPT 6 months after the PCI. ![]() Accordingly, the recent European, American, and Japanese guidelines for patients with AF undergoing PCI (5)(6) (7) typically recommend that a triple therapy needs to be deescalated to a dual therapy within 1 month after stenting and that the dual therapy be maintained up to 1 year after the stenting. Four recent randomized control trials (RCTs) involving patients with nonvalvular atrial fbrillation (NVAF) and coronary artery disease (CAD), the PIONEER PCI, RE-DUAL PCI, AUGUSTUS, and ENTRUST-AF PCI trials have shown a consistent reduction in the risk of bleeding, occurring any time during the frst year after percutaneous coronary intervention (PCI) in patients treated by a dual therapy with any of 4 direct-acting anticoagulants (DOACs) (dabigatran, rivaroxaban, apixaban, or edoxaban) and single antiplatelet therapy (SAPT), and that the risk of an ischemic event is equivalent between the dual therapy and triple therapy with a vitamin K antagonist (VKA) plus dual antiplatelet therapy (DAPT).
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