Non-vitamin K antagonist oral anticoagulants (NOACs) post-percutaneous coronary intervention: a network meta-analysis

Non–Vitamin K Antagonist Oral Anticoagulants in Coronary Artery Disease

“…Several meta-analyses of NOAC post-PCI studies showed an advantage of NOAC dual therapy over warfarin triple therapy with regard to major bleeding, without any differences in efficacy outcomes. 45,46 Importantly, however, recent meta analyses raised an important concern about a significant increase in the risk of stent thrombosis with double therapy. [47][48][49] These findings have sparked controversy over the best time to stop taking aspirin in AF patients undergoing PCI.…”

“…An indirect comparison of NOAC agents using a network meta-analysis also did not show superiority of one NOAC over another for AF patients post-PCI. 46…”

“…50 The European approach is still more cautious, recommending to terminate the triple treatment at discharge, 1 month, or 3 to 6 months depending on the individual's thrombotic and bleeding profile. 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 Patients with a high thrombotic risk should be treated with triple treatment for even up to 6 months, according to European guidelines. 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23…”

“…3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 Patients with a high thrombotic risk should be treated with triple treatment for even up to 6 months, according to European guidelines. 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 …”

“…An indirect comparison of NOAC agents using a network meta-analysis also did not show superiority of one NOAC over another for AF patients post-PCI. 46 The decision to select a certain NOAC drug should take into consideration features of the trial design that best fit the patient's characteristics (►Table 2). PIONEER-AF-PCI was the only trial that excluded participants who had previously experienced a cerebrovascular incident.…”