Short Versus Extended Duration of Triple Antithrombotic Therapy After Percutaneous Coronary Intervention in Patients Requiring Oral Anticoagulation: A Retrospective Single‐Center Study

BACKGROUND: Balancing ischemic and bleeding risks in patients undergoing percutaneous coronary intervention (PCI) who require anticoagulation remains a clinical challenge. While dual antithrombotic therapy (DAT) with a P2Y12 inhibitor and an oral anticoagulant reduces long-term bleeding risk, the optimal duration of triple antithrombotic therapy (TAT) in the immediate post-procedural phase is uncertain. AIMS: We aimed to evaluate clinical outcomes of short-duration ({7 days) of TAT to extended-duration (≥ 7 days) of triple therapy following PCI. METHODS: We conducted a retrospective observational study of 172 patients who underwent PCI. Of these, 109 received TAT for < 7 days, and 63 received TAT for ≥ 7 but < 28 days. The primary outcome was a composite endpoint of cardiovascular mortality, myocardial infarction, target lesion revascularization, and definite or probable stent thrombosis at 1 year. Secondary outcomes were gastrointestinal bleeding (BARC > 3) and intracranial hemorrhage. RESULTS: There were no statistically significant differences between the two groups in composite outcome (cardiovascular mortality, myocardial infarction, target vessel revascularization, or stent thrombosis at 1 year). Similarly, rates of major bleeding events did not differ significantly between the groups. CONCLUSION: Early de-escalation of TAT (within 7 days) demonstrated similar clinical outcomes to longer durations (< 7 days). Larger randomized controlled trials are warranted to further validate these findings.