Ivo Varvařovský
Patients with permanent indication of anticoagulation treatment benefit from addition of dual antiplatelet treatment after overcome acute coronary syndrome or coronary intervention. Such combined treatment is related to a high risk of bleeding. New antithrombotics (NOAC) have, in comparison with warfarin, a lower risk of serious bleeding and so when they are used, it is possible to expect lowering of these complications. We have retrospective data on safety for the combination of dual antiplatelet treatment with all new antithrombotics (dabigatran, apixaban, rivaroxaban). Utilization of new antithrombotics in secondary prevention of acute coronary syndrome will then require a significant lowering of the NOAC dose. So far we have persuasive data in this new indication only for a low dose of rivaroxaban.