[Warfarin combined with blood platelet inhibition].

Dual antiplatelet therapy (acetylsalicylic acid and a thienopyridine) is essential after coronary stent implantation, and in the treatment of acute coronary syndrome. Many patients also need oral anticoagulation. Unfortunately, there are no prospective randomised trials to guide therapy. Triple antithrombotic therapy with acetylsalicylic acid, clopidogrel and warfarin is most commonly used. This regimen can reduce the risk of thrombosis and thromboembolism, but is associated with an increased risk of bleeding. Measures that reduce the risk of complications are reduction of INR with careful monitoring, a short duration of triple therapy (when possible) and use of radial access and a bare metal stent.