The combination of anticoagulant and anti-platelet therapy in patients with atrial fibrillation: a comment on the recent ACC/AHA/ESC guidelines for the management of patients with atrial fibrillation

We appreciate your comment on the recommendations about anticoagulation in patients with atrial fibrillation (AF) who have undergone PCI. First, it is important to note that these statements appear in the recently published guidelines as a class IIb recommendation (level of evidence C). Since there are no prospective, randomized clinical trials specifically designed to address this issue, they are supported by the weakest level of evidence (consensus opinion of experts).1 Nevertheless, there are some important considerations. The aim of practice guidelines is to guide the treatment of ‘day-to-day’ patients. Those recommendations are drawn from clinical trials, which sometimes included patients who may …