ATRIAL FIBRILLATION PATIENTS' EXPERIENCES WITH COMBINATION ANTITHROMBOTIC THERAPY POST-PERCUTANEOUS CORONARY INTERVENTION

Up to 30% of patients with atrial fibrillation (AF) have coronary artery disease (CAD). Many undergo percutaneous coronary intervention (PCI), requiring antithrombotic therapy (ATT) with acetylsalicylic acid (ASA) and a P2Y12 inhibitor to prevent stent thrombosis, combined with warfarin or a direct oral anticoagulant (DOAC) for stroke prevention (triple therapy). In the setting of acute coronary syndrome (ACS) with PCI, or elective PCI with high-risk features, Canadian AF guidelines recommend limiting ASA to 30 days post-PCI, as continuation of triple therapy beyond 30 days results in increased bleeding without reduction in ischemic outcomes. They also recommend 1-12 months of clopidogrel, and oral anticoagulation with doses that may change through the 12 months post-PCI. The complexity of these regimens may contribute to unintended modifications, increasing the risk of thrombosis and/or bleeding. Our goal was to describe patient experiences with combination ATT, including unplanned modifications, after discharge from acute care.