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.