Outcomes in relation to antithrombotic therapy among patients with atrial fibrillation after percutaneous coronary intervention



Park, Jiesuck, Choi, Eue-Keun, Han, Kyung-Do, Kim, Bongseong, Choi, You-Jung, Lee, So-Ryoung, Kang, Jeehoon, Cha, Myung-Jin, Park, Kyung Woo, Oh, Seil
et al (show 1 more authors) (2020) Outcomes in relation to antithrombotic therapy among patients with atrial fibrillation after percutaneous coronary intervention. PLOS ONE, 15 (10). e0240161-.

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Abstract

<h4>Backgrounds</h4>We investigated the prognostic impact of antithrombotic regimens at 1-year after percutaneous coronary intervention (PCI) among patients with atrial fibrillation (AF).<h4>Method and results</h4>A total of 13,278 AF patients who underwent PCI from 2009 to 2013 were selected from Korean National Health Insurance Service database. Patients were categorized by antithrombotic regimens at 1-year after PCI: (1) OAC with or without single antiplatelet (OAC±SAPT); (2) triple therapy (TT) and (3) antiplatelets (APT) only. After propensity score matching, composite ischaemia (death, myocardial infarction, and stroke), composite bleeding (intracranial hemorrhage and gastrointestinal bleeding), and a composite clinical outcome (composite ischaemia and bleeding) were compared. Of total population, 1,100 (8.3%), 746 (5.6%), and 11,432 (86.1%) were treated with OAC±SAPT, TT, and APT only, respectively. Compared to OAC±SAPT group, the TT group had significantly higher risk of the composite clinical outcome (hazard ratio [HR] 1.46, 95% confidence interval [CI] 1.00-2.13) attributed to a higher trend in both ischaemia (HR 1.63, 95% CI 0.99-2.67) and bleeding (HR 1.22, 95% CI 0.69-2.13). The APT only group showed a higher risk of ischaemia (HR 1.85, 95% CI 1.25-2.74), despite a lower risk of bleeding (HR 0.55, 95% CI 0.32-0.94) compared to OAC±SAPT group.<h4>Conclusions</h4>OAC±SAPT was associated with better clinical outcomes compared to TT or APT only treatments, beyond 1-year after PCI among Asians with AF.

Item Type: Article
Uncontrolled Keywords: Humans, Intracranial Hemorrhages, Atrial Fibrillation, Myocardial Infarction, Gastrointestinal Hemorrhage, Postoperative Complications, Anticoagulants, Platelet Aggregation Inhibitors, Prognosis, Treatment Outcome, Drug Therapy, Combination, Prevalence, Risk Factors, Aged, Middle Aged, Female, Male, Coronary Artery Disease, Stroke, Republic of Korea, Percutaneous Coronary Intervention
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: 02 Jul 2021 08:12
Last Modified: 18 Jan 2023 21:37
DOI: 10.1371/journal.pone.0240161
Open Access URL: http://doi.org/10.1371/journal.pone.0240161
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3128525