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Comment & Response
December 4, 2019

Clinical Considerations Prior to Transition From Triple Antithrombotic Therapy to Dual Antithrombotic Therapy

Author Affiliations
  • 1Department of Pharmacy Practice and Translational Research, University of Houston College of Pharmacy, Houston, Texas
  • 2Department of Pharmacy Practice and Science, University of Kentucky College of Pharmacy, Lexington
JAMA Cardiol. 2020;5(1):111. doi:10.1001/jamacardio.2019.4542

To the Editor We read with great interest the publication by Lopes et al1 regarding the network meta-analysis assessing antithrombotic treatment in patients with atrial fibrillation (AF). The authors used a bayesian network meta-analysis to compare the efficacy and safety of dual antithrombotic therapy (DAT) with triple antithrombotic therapy with respect to vitamin K antagonist (VKA) anticoagulants vs non-VKA anticoagulants. The study concluded that in patients with AF undergoing percutaneous coronary intervention (PCI), a non-VKA and P2Y12 inhibitor vs VKA and dual antiplatelet therapy is associated with a lower incidence of bleeding (odds ratio, 0.49; 95% CI, 0.30-0.82) and a similar rate of ischemic outcomes (odds ratio, 1.02; 95% CI, 0.71-1.97).1

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