Is it sufficient to maintain patients with atrial fibrillation and established PAD on a DOAC or VKA alone, or is there an additional benefit to adding an antiplatelet agent for CVD benefit?
If so, would you prefer a P2Y12i over low-dose aspirin?
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Is it sufficient to maintain patients with atrial fibrillation and established PAD on a DOAC or VKA alone, or is there an additional benefit to adding an antiplatelet agent for CVD benefit?
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1 Answer
Mednet MemberInvited Expert
Cardiology · Yale University School of Medicine
Answered on
If they have medically managed PAD with no recent intervention/revascularization, anticoagulation alone should be sufficient especially if their bleeding risk is not low.
In general, most patients on anticoagulation for AF do not need to also be on anti-platelet agents for secondary prevention. Exceptions may be low bleeding risk patients with higher risk disease (remote CABG with occluded grafts, patients s/p left main PCI, disease in multiple vascular beds, prior stent thrombosis, etc.)
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