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Managing cath-lab interventions in patients taking warfarinFeb 15, 2010 09:55 EST
Some practitioners argue that patients undergoing chronic anticoagulant management should only ever receive bare-metal stents, while others insist that drug-eluting stents are a possibility, citing successful triple (warfarin/clopidogrel/aspirin) or novel types of dual (warfarin/clopidogrel) antiplatelet therapies. Two recent articles seem to complicate the decision-making process by creating an elaborate treatment algorithm based on risk assessment and arguing for a new modified approach to antiplatelet therapy for those taking warfarin. What is your approach to this dilemma?
Baber U, Akhter M, et al. Efficacy of modified dual antiplatelet therapy combined with warfarin following percutaneous coronary intervention with drug-eluting stents.
J Invasive Cardiol 2010; 22:80-3. Abstract.
Patti G, Di Sciascio G. Antithrombotic strategies in patients on oral anticoagulant therapy undergoing percutaneous coronary intervention: a proposed algorithm based on individual risk stratification. Catheter Cardiovasc Interv 2010; 75:128-34. Abstract.