{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T06:16:38Z","timestamp":1791353798072,"version":"4.3.1"},"reference-count":93,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"18","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2019,4,30]]},"abstract":"<jats:p>\n            Antiplatelet therapy is the mainstay for the treatment of acute and chronic arterial disease involving the coronary and peripheral beds. However, questions remain about optimal antithrombotic therapy for long-term treatment of chronic vascular disease. The observation that dual antiplatelet therapy with acetylsalicylic acid and clopidogrel was associated with lower thrombotic event rates than acetylsalicylic acid monotherapy in patients with acute coronary syndromes and those undergoing percutaneous coronary intervention changed the treatment paradigm. Moreover, the demonstration that more pharmacodynamically potent P2Y\n            <jats:sub>12<\/jats:sub>\n            inhibitors than clopidogrel were associated with fewer thrombotic event occurrences further solidified the dual antiplatelet therapy approach. However, recurrent thrombotic events occur in \u22481 in 10 patients in the first year following an acute coronary syndrome event, despite treatment with the most potent P2Y\n            <jats:sub>12<\/jats:sub>\n            inhibitors, a limitation that has stimulated interest in exploring the efficacy and safety of approaches using anticoagulants on top of antiplatelet therapy. These investigations have included treatment with very-low-dose oral anticoagulation, and even its replacement of acetylsalicylic acid in the presence of a P2Y\n            <jats:sub>12<\/jats:sub>\n            inhibitor, in patients stabilized after an acute coronary syndrome event. Recent basic and translational studies have suggested noncanonical effects of coagulation factor inhibition that may further modulate clinical benefits. This in-depth review will discuss developments in our understanding of the roles that platelets and coagulation factors play in atherothrombosis and review the rationale and clinical evidence for combining antiplatelet and oral anticoagulant therapy in patients with coronary and peripheral artery disease.\n          <\/jats:p>","DOI":"10.1161\/circulationaha.118.033580","type":"journal-article","created":{"date-parts":[[2019,4,29]],"date-time":"2019-04-29T18:10:36Z","timestamp":1556561436000},"page":"2170-2185","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":91,"title":["Combination Antiplatelet and Oral Anticoagulant Therapy in Patients With Coronary and Peripheral Artery Disease"],"prefix":"10.1161","volume":"139","author":[{"given":"Paul A.","family":"Gurbel","sequence":"first","affiliation":[{"name":"Inova Center for Thrombosis Research and Drug Development, Inova Heart and Vascular Institute, Falls Church, VA (P.A.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith A.A.","family":"Fox","sequence":"additional","affiliation":[{"name":"British Heart Foundation Centre for Cardiovascular Sciences, University of Edinburgh, United Kingdom (K.A.A.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Udaya S.","family":"Tantry","sequence":"additional","affiliation":[{"name":"Sinai Center for Thrombosis Research, Sinai Hospital of Baltimore, MD (U.S.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugo","family":"ten Cate","sequence":"additional","affiliation":[{"name":"Laboratory for Clinical Thrombosis and Hemostasis, Departments of Internal Medicine and Biochemistry, Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Netherlands (H.t.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey I.","family":"Weitz","sequence":"additional","affiliation":[{"name":"Thrombosis and Atherosclerosis Research Institute and McMaster University, Hamilton, Canada (J.I.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","unstructured":"communitymedicine4asses. 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