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DOACs and Antiplatelets, if pt is over 65 --> OAC indicated 🩸 if pt…

- - - - for stent thrombosis prevention, DAPTs are used
        for strokes, OAC are used
        when you combine DAPT + OAC = higher risk of major bleeding
  - - - non-valvular A-fib pts
- - - - low bleed risk, less renal excreted
  - - - ALWAYS reassess triple therapy after 1 month
      - reassess anytime a clot happens, bleeding event, changes to med conditions and medications
      - tell pt to NEVER STOP THERAPY without consulting a HCP first
  - - - DOAC + clopidogrel (skip ASA)
    - - triple therapy short term (warfarin + ASA + clopidogrel)
- - - - eGFR <30, cirrhosis, active malignancy, Hgb <110, low platelets, long term OAC use, major surgery the past month
    - - eGFR 30-59, Hgb 110-129, 75y+, NSAID/steroid use
  - - - DM, smoking, ACS hx, prior stent clot, eGFR <60
    - - 3 stents, bifurcations, long stents, LAD involvement
- - - - DOAC + P2Y12i
        
        for PCI without clotting risks OR for ACS wtihout PCI
        
        for 12 months post-PCI
    - - OAC + ASA + P2Y12i (short-term)
        
        for ACS with PCI OR PCI with high clotting risks
        
        for 1 day to 1 month
        
        then switch to dual therapy of OAC + P2Y12i
- - - - all the other trials compared dual to triple therapy directly, whereas AUGUSTUS compared OACs to each other and antiplatelets to each other
- - - - consider 3-6 months, then switch to single antiplatelt therapy after with ASA or clopidogrel alone