Optimal Antithrombotic Strategy in Patients With Atrial Fibrillation After Coronary Stent Implantation.
10.4070/kcj.2011.41.10.578
- Author:
Sung Won JANG
1
;
Tai Ho RHO
;
Dong Bin KIM
;
Eun Joo CHO
;
Beom June KWON
;
Hun Jun PARK
;
Woo Seung SHIN
;
Ji Hoon KIM
;
Jong Min LEE
;
Keon Woong MOON
;
Yong Seog OH
;
Ki Dong YOO
;
Ho Joong YOUN
;
Man Young LEE
;
Wook Sung CHUNG
;
Ki Bae SEUNG
;
Jae Hyung KIM
Author Information
1. Division of Cardiology, Department of Internal Medicine, The Catholic University of Korea School of Medicine, Seoul, Korea. tairho@catholic.ac.kr
- Publication Type:Original Article
- Keywords:
Atrial fibrillation;
Angioplasty;
Stents;
Anticoagulants;
Platelet aggregation inhibitors
- MeSH:
Angioplasty;
Anticoagulants;
Atrial Fibrillation;
Comorbidity;
Follow-Up Studies;
Heart Failure;
Hemorrhage;
Humans;
Hypertension;
Incidence;
Male;
Percutaneous Coronary Intervention;
Platelet Aggregation Inhibitors;
Risk Factors;
Stents;
Stroke;
Tetrazoles;
Warfarin
- From:Korean Circulation Journal
2011;41(10):578-582
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND AND OBJECTIVES: Little evidence is available on the optimal antithrombotic therapy following percutaneous coronary intervention (PCI) in patients with atrial fibrillation (AF). We investigated the outcomes of antithrombotic treatment strategies in AF patients who underwent PCI. SUBJECTS AND METHODS: Three hundred sixty-two patients (68.0% men, mean age: 68.3+/-7.8 years) with AF and who had undergone PCI with stent implantation between 2005 and 2007 were enrolled. The clinical, demographic and procedural characteristics were reviewed and the stroke risk factors as well as antithrombotic regimens were analyzed. RESULTS: The accompanying comorbidities were as follows: hypertension (59.4%), diabetes (37.3%) and congestive heart failure (16.6%). The average number of stroke risk factors was 1.6. At the time of discharge after PCI, warfarin was prescribed for 84 patients (23.2%). Cilostazol was used in addition to dual antiplatelet therapy in 35% of the patients who did not receive warfarin. The mean follow-up period was 615+/-385 days. The incidences of major adverse cardiac events (MACE), stroke and major bleeding were 11.3%, 3.6% and 4.1%, respectively. By Kaplan-Meier survival analysis, warfarin treatment was not associated with a lower risk of MACE (p=0.886), but it was associated with an increased risk of major bleeding (p=0.002). CONCLUSION: Oral anticoagulation therapy after PCI may increase hemorrhagic events in Korean AF patients.
