Current Status of Antithrombotic Strategy for Elderly Patients With Atrial Fibrillation and Acute Coronary Syndrome After Stent Implantation in Beijing Area
10.3969/j.issn.1000-3614.2018.01.005
- VernacularTitle:北京地区高龄心房颤动合并急性冠状动脉综合征患者支架置入术后抗栓策略的现状
- Author:
Bo-Yang ZHANG
1
;
Peng-Fei LIU
;
Nan-Nan WANG
;
Yu-Bin WANG
;
Ru-Chen LIU
;
Ge WANG
;
Xiu-Feng XIE
;
Hai-Feng YUAN
;
Hai-Hong TANG
;
Li ZHAO
;
Yun-Dai CHEN
;
Kang-Xing SONG
;
Yi-Da TANG
;
Cheng-Jun GUO
;
Yun-Tian LI
;
Zhi-Min MA
;
Xian WANG
;
Dang-Sheng HUANG
;
Shou-Li WANG
;
Tian-Chang LI
Author Information
1. 中国人民解放军海军总医院 心内科
- Keywords:
Atrial fibrillation;
Acute coronary syndrome;
Elderly people
- From:
Chinese Circulation Journal
2018;33(1):30-35
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To investigate the current status of antithrombotic strategy for elderly patients with atrial fibrillation (AF) and acute coronary syndrome (ACS) after stent implantation in Beijing area and to study the safety and efficacy of different therapeutic strategy. Methods: A total of 467 relevant patients were enrolled by re-travelling electronic medical records from 12 hospitals in Beijing area. The patients' mean age was (78.70±3.32) years and they were divided into 2 groups by antithrombotic therapy condition: Triple therapy group, n=17 (3.64％), Double therapy group, n=450 (96.36％). The incidence of major adverse cardiac and cerebral events (MACCE) including all-caused death, non-fatal myocardial infarction, stent thrombosis, target vessel revascularization (TVR), stoke and bleeding was compared between Triple therapy group and Double therapy group.Results: The medication in Double therapy group included aspirin+ticagrelor, aspirin+clopidogrel, clopidogrel+warfarin and cilostazol+clopidogrel; in Triple therapy group was aspirin+clopidogrel+warfarin. Patient with HAS-BLED score≥3 was defined as high risk of bleeding and they were all treated by double therapy; HAS-BLED<3 was defined as low risk of bleeding, only 5.03％ patients were treated by triple therapy. 3 patients in Triple therapy group and 33 in Double therapy group suffered from gastrointestinal bleeding, P=0.338; 6 patients in Triple therapy group and 128 in Double therapy group had MACCE, P=0.589; 3 and 80 patients died in Triple therapy group and Double therapy group, P=0.766. Conclusion: Triple therapy was rarely used in elderly AF and ACS patients after stent implantation, double therapy was the main strategy; the incidence of MACCE and mortality were similar between triple and double therapies; patients with triple therapy had the higher incidence of gastrointestinal bleeding.
