Long-term oral anticoagulation (OAC) is an essential aspect in the
treatment of patients with atrial fibrillation (AF). Approximately
70–80% of all patients in AF have an indication for lifelong OAC, and
coronary artery disease coexists in 20–30% of these
patients.1,2 Balancing the risk of bleeding and
thromboembolism is crucial in the management of patients on OAC, even
more in cases when AF is associated with percutaneous coronary
intervention (PCI).
Furthermore as the number of available oral antiplatelet and oral
anticoagulant agents continue to grow, so does the uncertainty about
various permutations and combinations regarding optimal combination
therapy. Given the high proportion of patients undergoing PCI on
antiplatelets and requiring OAC for conditions particularly like AF, it
is important that physicians are aware of the clinical implications and
management of these overlapping conditions. The periprocedural
management of anticoagulated patients is critical, but clinical practice
varies widely between clinicians, hospitals, and countries. The addition
of these oral anticoagulation often requires modification of the
antiplatelet regimen to optimize patient outcomes by balancing the risk
of bleeding with the risk for ischemic events.
The need of this study was to determine the diversity in the
antiplatelet and anticoagulation treatment of patients with Non Valvular
AF or flutter who develop ACS or undergo PCI in India. Thus, in view of
the lack of data available, also, determining the guidance towards
management of such patients in India.