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AF with PCI-Antithrombotics — EECC MCQ

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HardCardiologyAF with PCI-AntithromboticsEECC

A 62-year-old with NSTEMI undergoes PCI with DES. He also has an indication for oral anticoagulation due to AF. What antithrombotic regimen is generally preferred early after PCI?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: CBrief triple therapy followed by OAC plus clopidogrel

Guidelines favor minimizing triple therapy duration (often <=1 week) then using dual therapy (OAC + P2Y12 inhibitor) to reduce bleeding while maintaining ischemic protection. Prolonged triple therapy increases bleeding risk; antiplatelet monotherapy without OAC is inappropriate in AF. The keyed option is the best answer only in the stated clinical context. The alternatives would require different findings, contraindications, thresholds or treatment circumstances that are not present. Apply the recommendation alongside comorbidity, interactions, patient preference and the current local pathway. Review response and safety-net for deterioration, treatment failure or adverse effects; reconsider the diagnosis if the expected response does not occur.

Reference: ACC/AHA/SCAI (2021): Guideline for Coronary Artery Revascularization: https://bnf.nice.org.uk/drugs/warfarin-sodium/