Lee, So-Ryoung, Jung, Jin-Hyung, Choi, Eue-Keun, Lee, Seung-Woo, Kwon, Soonil, Park, Ji-Suck, Kang, Jeehoon, Han, Kyung-Do, Park, Kyung Woo, Oh, Seil et al (show 1 more authors)
(2022)
Net clinical benefit of antithrombotic therapy for atrial fibrillation patients with stable coronary artery disease.
FRONTIERS IN CARDIOVASCULAR MEDICINE, 9.
991293-.
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Net clinical benefit of antithrombotic therapy for atrial fibrillation patients with stable coronary artery disease.pdf - Open Access published version Download (5MB) | Preview |
Abstract
<h4>Objectives</h4>To compare the net clinical benefit of oral anticoagulant (OAC) monotherapy to OAC plus single antiplatelet therapy (SAPT) in patients with atrial fibrillation (AF) and stable coronary artery disease (CAD) at 1- and 3-year after percutaneous coronary intervention (PCI).<h4>Background</h4>It has not been studied whether the net clinical benefit of the antithrombotic treatment options differs depending on the elapsed time from the index PCI.<h4>Methods</h4>Using the Korean nationwide claims database, we included AF patients who underwent PCI from 2009 to 2019 and constructed two cohorts: 1- and 3-year after PCI. In each cohort, the baseline characteristics of two groups were balanced using propensity score weighting. Ischemic stroke, myocardial infarction, major bleeding, and composite clinical outcomes were analyzed.<h4>Results</h4>Among patients with 1-year after PCI, OAC monotherapy (<i>n</i> = 678), and OAC plus SAPT (<i>n</i> = 3,159) showed comparable results for all clinical outcomes. In patients with 3-year after PCI, OAC monotherapy (<i>n</i> = 1,038) and OAC plus SAPT (<i>n</i> = 2,128) showed comparable results for ischemic stroke and myocardial infarction, but OAC monotherapy was associated with a lower risk of composite clinical outcomes (HR 0.762, 95% CI 0.607-0.950), mainly driven by the reduction of major bleeding risk (HR 0.498, 95% CI 0.345-0.701).<h4>Conclusion</h4>Oral anticoagulant monotherapy may be a comparable choice for patients with AF and stable CAD compared to OAC plus SAPT. In patients with stable CAD more than 3-year after index PCI, OAC monotherapy would be a better choice, being associated with less major bleeding and a positive net clinical benefit.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | atrial fibrillation, coronary artery disease, antithrombotic therapy, oral anticoagulant, antiplatelet agent |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 17 Oct 2023 11:02 |
| Last Modified: | 17 Oct 2023 11:02 |
| DOI: | 10.3389/fcvm.2022.991293 |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3173811 |
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