Medicine: Treatment of atrial fibrillation under special circumstances

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  • 2018 11 Medicine, Treatment of atrial fibrillation under special circumstances
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Anticoagulants are blood thinners. Antiplatelet agents also blood are thinners. However, anticoagulants are active primarily in the deep veins of the body.
Anticoagulants and antiplatelet agents can be combined. Even combined three or four times over.
If you should have severe coronary heart disease (CHD) or an acute heart attack (an acute myocardial infarction), doctors can go to your heart with a catheter and treat the narrowed or very narrowed coronary arteries directly on the spot with the catheter: Percutaneous coronary intervention (PCI).
Atrial fibrillation is when your heart beats normally, but nevertheless the atria of your heart (not the large chambers of your heart, but the atria of your heart) flicker. If you should have atrial fibrillation, the blood in the atrium is not very effectively pumped into the ventricle of the heat. The blood can linger and form a blood clot. This blood clot later can cause a stroke. It is estimated that approximately 15% of all strokes go back to atrial fibrillation.
What is the best treatment for patients who have both atrial fibrillation and coronary heart disease and have had a percutaneous coronary intervention (PCI)? We exclude for the moment tablets for high blood pressure and elevated cholesterol. How many tablets should such a patient receive for the atrial fibrillation and to prevent a stroke?
At the end of 2016 and in 2017, two clinical studies have been published which looked at this question. Both clinical studies showed that triple therapy against blood clots is too much. It is only equally effective but causes significantly more side effects. Dual therapy against blood clots is preferable.


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