C20-2915-227-1771

Introduction: Recently, three antithrombotic strategies are used in the management of patient with ischemic heart disease and atrial fibrillation, therefore two antiplatelet agents plus one anticoagulant agent are indicated accordingly. However, benefits of reducing ischemic and thromboembolic events should outweigh high bleeding risk of triple therapy as compared to double therapy.

Objective: To review prescribing pattern of triple antithrombotic therapies in atrial fibrillation patients undergoing Percutaneous Coronary Intervention (PCI) in HSB.

Methods: A retrospective cohort study involved all atrial fibrillation patients with post PCI in HSB. All patients’ name and ID undergoing PCI in 2018 from ICL laboratory HSB and patient receiving NOAC from the list name in out-patient pharmacy department had been collected and retrieved from e-HIS system.

Results: Only two patients receive Triple Antithrombotic Therapies (TAT) with warfarin. Subject Y and Z with duration of 6 months and 3 months respectively with no hospitalization had been recorded. For TAT with NOAC, subject A received aspirin, clopidogrel and rivaroxaban 15mg daily for 6 months then clopidogrel and rivaroxaban 15mg daily for another 6 months and continue with rivaroxaban for lifelong. Treatment plan for subject C is similar to subject A with substitution of Dabigatran 150mg twice daily as new oral anticoagulant. However for subject B there is different in treatment plan.

Conclusion: TAT is not well practiced in HSB although it is suggested and proposed in European Health Journal and implied in other country. However, bleeding risk is also main concern in using TAT as compared to double therapy.