Management of anticoagulation for a patient undergoing percutaneous cardiac intervention (PCI)

Join Professor John Camm and Professor Christoph Bode as they review the case study of a patient who presented to the emergency department with acute ST-elevation myocardial infarction (STEMI) and a prior history of atrial fibrillation (AF). This patient required PCI and stenting, and the potentially-complicated management of his post-PCI therapy, including anticoagulation.

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Christoph Bode

University of Freiburg

Freiburg, Germany


In this video, filmed at ACC 2018, a case study of a 71-year-old male with acute STEMI and a 20-year history of AF is presented. The management of ongoing therapy is discussed with consideration of recent data, including the WOEST study, in which non-vitamin K oral anticoagulant (NOAC) and antiplatelet therapy are adjusted. Two other major trials, PIONEER AF-PCI and RE-DUAL PCI are also examined, moving on to how guidelines are beginning to reflect the results of recent studies and how it is becoming simpler to manage patients with dual, rather than triple therapy following acute MI in the AF patient.

  • Target audience
    This educational activity is designed for hospitalists, haematologists, interventional cardiologists, internists/physicians, surgeons and any other healthcare professional with an interest or role in the management of patients on anticoagulation undergoing percutaneous cardiac intervention.
  • Learning objectives
    After completing this educational activity, participants should be able to:
    1. Identify approaches to periprocedural anticoagulation in patients with STEMI undergoing percutaneous coronary intervention (PCI)
    2. Assess the balance between bleeding risk, stroke risk and stent thrombosis after PCI
    3. Recognise the benefits of dual therapy over triple therapy following acute MI in the AF patient
  • Disclosures
    Professor John Camm, St George’s University of London, UK
    • Advisor for: Boehringer Ingelheim, Daiichi Sankyo
    • Consultant (retained) for: Boehringer Ingelheim
    • Received honoraria from: Bayer, Daiichi Sankyo, BMS-Pfizer
    Professor Christoph Bode, University of Freiburg, Germany
    • Receipt of honoraria or consultation fees from: Behringer Ingelheim, Bayer, MSD, Astra Zeneca, Daiichi Sankyo
  • Funding
    This independent educational activity is supported by funding from Boehringer Ingelheim. PCM Scientific is the medical education company acting as scientific secretariat and organiser for this programme. The activity is run independently of the financial supporter and all content is created by the faculty. No funder has had input into the content of the activity.