Duration of triple antithrombotic therapy in patients with atrial fibrillation following percutaneous coronary intervention: A single-center retrospective review

Objectives: The optimal duration of triple antithrombotic therapy (TAT) consisting of an anticoagulant and dual antiplatelet therapy is unclear in patients with atrial fibrillation (AF) on anticoagulation who require percutaneous coronary intervention (PCI). Guidelines recommend TAT be continued up to 1 week in most patients or up to 1 month in patients at increased thrombotic risk. However, these recommendations are based on expert opinion due to the lack of randomized controlled trials directly comparing TAT duration. The purpose of this study was to evaluate the optimal duration of TAT in patients with AF following PCI. Materials and Methods: This study was a single-center, retrospective cohort study. Subject cohorts were determined based on TAT duration of <1 week (ultra-short group), 1 week–1 month (short group), or 1 month–1 year (extended group). The primary outcome was a composite of major or clinically relevant non-major bleeding events. Secondary outcomes included ischemic events, deaths, and hospitalizations for revascularization. Results: During the study, 39 patients met criteria for inclusion and were categorized as follows: Ultra-short group n = 10 (25.6%), short group n = 24 (61.5%), and extended group n = 5 (12.8%). There was no difference in the primary outcome between the groups at 1 year. In addition, there were no differences in any of the secondary outcomes. Conclusion: While this study did not find any differences in outcomes between groups, these findings should be viewed as descriptive and exploratory due to the small sample size. Larger studies are needed to further evaluate the effects of varying durations of TAT.