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Current Use of Oral Anticoagulants and Prognostic Analysis in Patients with Atrial Fibrillation Undergoing Coronary Stenting

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文摘 It is currently believed that triple oral antithrombotic therapy in patients with atrial fibrillation (AF) after percutaneous coronary intervention (PCI) should be recommended if there are no contraindications. However, selecting triple therapy for AF patients undergoing PCI is still challenging when bleeding risk is considered. This study aimed to investigate the current use of oral anticoagulants (Vitamin K antagonists [VKA]) and perform prognostic analysis in real-world patients with AF undergoing coronary stenting. Methods: A total of 276 consecutive coronary artery disease (CAD) patients with or without AF undergoing coronary stenting were retrospectively evaluated and analyzed. The univariate and multivariate analyses were conducted to explore the current use of VKA and prognosis of patients with AF undergoing coronary stenting. The primary end-point was composite of all-cause death, nonfatal recurrent myocardial infarction, stroke, serious bleeding events, unplanned repeat revascularization, and worsening heart failure at 12-month follow-up after coronary stenting. Results: AF patients undergoing coronary stenting have more clinical concomitant diseases. Only 9.0% AF patients after coronary stenting received triple antithrombotic therapy (VKA, aspirin, and clopidogrel) at discharge. AF was independently associated with increased risk of the 12-month composite end-points (relative risk = 5.732, 95% confidence interval 1.786-18.396,P = 0.003). Conclusions: In real-life AF patients undergoing coronary stenting, guideline-recommended VKA was less used. AF patients had adjusted worse prognosis during 12-month follow-up after discharge. It is of utmost importance to improve the current status of oral anticoagulants use.
来源 Chinese Medical Journal ,2017,130(12):1418-1423 【核心库】
DOI 10.4103/0366-6999.207460
关键词 Antithrombotic Therapy ; Atrial Fibrillation ; Coronary Artery Disease ; Percutaneous Coronary Intervention ; Prognosis
地址

Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, Liaoning, Dalian, 116011

语种 英文
文献类型 研究性论文
ISSN 0366-6999
学科 医药、卫生
基金 supported by grants from the Health and Family Planning Commission of Liaoning, China ;  the Science and Technology Program of Dalian, China
文献收藏号 CSCD:6009463

参考文献 共 24 共2页

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