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Percutaneous Coronary Intervention in Anticoagulated Patients and Balancing the Risk of Stroke and Bleeding: To Interrupt or Not To Interrupt?

Benjamin J. Wrigley, MRCP; Eduard Shantsila, MD; Gregory Y. H. Lip, MD
Author and Funding Information

From the Haemostasis Thrombosis and Vascular Biology Unit, University of Birmingham Centre for Cardiovascular Sciences, City Hospital.

Correspondence to: Gregory Y. H. Lip, MD, the Haemostasis Thrombosis and Vascular Biology Unit, University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham B18 7QH, England; email: g.y.h.lip@bham.ac.uk


Financial/nonfinancial disclosures: The authors have reported to CHEST the following conflicts of interest: Dr Lip has served as a consultant for Bayer, Astellas, Merck, AstraZeneca, Sanofi, Aryx, Portola, Biotronic, and Boehringher and has been on the speakers bureau for Bayer, Boehringher, and Sanofi. Drs Wrigley and Shantsila reported that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2010 American College of Chest Physicians


Chest. 2010;138(4):771-774. doi:10.1378/chest.10-0789
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Extract

Coronary artery disease coexists in 20% to 30% of patients with atrial fibrillation (AF),1 and some will inevitably require coronary angiography and percutaneous coronary intervention (PCI). Performing PCI in this cohort of patients is often challenging because many are taking oral anticoagulation for thromboprophylaxis, usually in the form of warfarin. Two important issues must be considered: first, whether to interrupt or continue anticoagulation during the periprocedural period; second, the choice of long-term antithrombotic therapy to follow PCI.

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