AF, DAPT and oral anticoagulation

Q: For patients with Atrial fibrillation (AF) dual antiplatelet treatment (DAPT) should be stopped once oral anticoagulation is started?

A) True

B) False

Answer: A

All patients with atrial fibrillation qualifies for oral anticoagulation unless there is a contraindication (or patient refusal). Patients with severe Transient Ischemic Attack (TIA) who get diagnosed with AF should be started on warfarin or a direct oral anticoagulant (DOAC). And, once it is on board DAPT should be stopped to avoid bleeding issues, unless other strong indications are present for DAPT. 

DOACs achieve effect within hours and do not require heparin bridge.

#cardiology

Reference:

1. Barra S, Providência R. Anticoagulation in atrial fibrillation. Heart. 2021 Mar;107(5):419-427. doi: 10.1136/heartjnl-2020-316728. Epub 2020 Oct 28. PMID: 33115763.

2. 2019 AHA/ACC/HRS Focused Update of the 2014 Guideline for Management of Patients with Atrial Fibrillation: link: https://www.acc.org/-/media/Non-Clinical/Files-PDFs-Excel-MS-Word-etc/Guidelines/2019/2019-Afib-Guidelines-Made-Simple-Tool.pdf (last accessed September 5, 2022)