Category: Federal Forum Posters
Purpose: Triple therapy is a medication regimen that consists of aspirin, a P2Y12 inhibitor, and an oral anticoagulant. The most common clinical indication for triple therapy is in patients with atrial fibrillation who have acute coronary syndrome or recent percutaneous coronary intervention with stent implantation. The use of direct-acting oral anticoagulants (DOACs) as an alternative to warfarin in triple therapy has been evaluated in multiple studies, but none compared safety between DOACs. Thus, our objective is to compare bleeding rates between DOACs used in triple therapy to determine whether use of a particular DOAC should be favored at our institution.
Methods: Pending submission to the Institutional Review Board for approval, a retrospective chart review will be conducted of patients prescribed triple therapy from 2013 through 2017. Inclusion criteria consists of patients age 18 years or older with an indication for triple therapy prescribed aspirin, clopidogrel, and a DOAC. The primary safety outcome will be clinically significant bleeding within twelve months of starting triple therapy. Bleeding will be defined according to the Thrombolysis in Myocardial Infarction definition and stratified into major bleeding, minor bleeding, and bleeding requiring medical attention. Comparative analysis will serve to assess whether a preferential DOAC should be utilized to maximize patient safety outcomes in the setting of triple therapy.
Results: Not applicable
Conclusion: Not applicable
Isabel Cwikla– PGY1 Pharmacy Resident, South Texas Veterans Health Care System, San Antonio, TX