Real-World Antithrombotic Therapy in Atrial Fibrillation Patients with a History of Percutaneous Coronary Intervention.

Real-World Antithrombotic Therapy in Atrial Fibrillation Patients with a History of Percutaneous Coronary Intervention. Int Heart J. 2019 Nov 15;: Authors: Horiguchi A, Fukaya H, Oikawa J, Shirakawa Y, Kobayashi S, Arakawa Y, Nishinarita R, Nakamura H, Ishizue N, Igarashi G, Satoh A, Kishihara J, Niwano S, Ako J Abstract Optimal antithrombotic strategy for atrial fibrillation (AF) patients with a history of percutaneous coronary intervention (PCI) has been under debate. The actual prescription trend of antithrombotic therapy for these patients remains unclear, especially in chronic phase.Patients with AF having at least a 1-year history of PCI were retrospectively evaluated in 2010, 2012, 2014, and 2016. A total of 266 patients were finally enrolled in this study. The proportion of patients prescribed with oral anticoagulants (OACs) gradually increased over the study period (56%, 67%, 73%, and 74% in 2010, 2012, 2014, and 2016, respectively). According to the type of OACs, the proportion of direct oral anticoagulant (DOAC), launched in 2011, increased compared with warfarin (DOAC versus warfarin = 3% versus 64% in 2012, 24% versus 49% in 2014, and 32% versus 42% in 2016). Single antiplatelet therapy (SAPT) with OAC was the most popular prescription every year, and its proportion increased over the study period (41%, 44%, 55%, and 59%, respectively). The proportion of OAC monotherapy gradually increased (2%, 3%, 8%, and 9%, respectively), whereas that of t...
Source: International Heart Journal - Category: Cardiology Tags: Int Heart J Source Type: research

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SUMMARY BACKGROUND: The AnTicoagulation and Risk factors In Atrial fibrillation (ATRIA) risk score used to detect the thromboembolic and hemorrhagic risk in atrial fibrillation patients has been shown recently to predict poor clinical outcomes in patients with acute myocardial infarction (ACS), regardless of having atrial fibrillation (AF). We aimed to analyze the relationship between different risk scores and contrast-induced nephropathy (CIN) development in patients with ACS who underwent urgent percutaneous coronary intervention (PCI) and compare the predictive ability of the ATRIA risk score with the MEHRAN risk score....
Source: Revista da Associacao Medica Brasileira - Category: General Medicine Source Type: research
Source: Cardiovascular Drugs and Therapy - Category: Cardiology Source Type: research
For patients with atrial fibrillation (AF) who undergo percutaneous coronary intervention (PCI), antithrombotic therapy including oral anticoagulants (OAC) and antiplatelets are indicated. The optimal combination is not known.  We investigated the efficacy and safety of different antithrombotic strategies in patients with AF undergoing PCI.PUBMED and EMBASE were searched through September 2019 for randomized trials investigating the efficacy and safety of different antithrombotic strategies in patients with AF undergoing PCI and/or acute coronary syndrome.
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research
The incidence, recurrence rate and prognostic significance of atrial fibrillation or flutter (AF) following hospital discharge after percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) for left main coronary artery disease (LMCAD) are unknown. We sought to determine the 3-year incidence and clinical impact of post-discharge AF in patients with LMCAD treated with PCI or CABG. In the EXCEL trial, 1905 patients with LMCAD were randomized to PCI versus CABG. We analyzed the occurrence of post-discharge AF through 3 years and its time-adjusted association with adverse outcomes.
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research
ABSTRACTBackgroundTrends and clinical factors associated with prescribing choices for oral P2Y12 inhibitors (P2Y12-I) remain unknown for patients on chronic dialysis, i.e., with end-stage renal disease (ESRD).MethodsFrom 2011 –2014 U.S. Renal Data System registry, we identified 36,542 ESRD patients who received new prescriptions for P2Y12-I (median age 64.0 years and 54% males). Of the cohort, 93% were receiving hemodialysis and 7% on peritoneal dialysis. We analyzed trends and investigated clinical factors associated with specific P2Y12-I prescribed.ResultsClopidogrel was prescribed for 95%, prasugrel for 3%, and ti...
Source: Cardiovascular Drugs and Therapy - Category: Cardiology Source Type: research
Publication date: Available online 12 November 2019Source: Canadian Journal of CardiologyAuthor(s): Mohammed Shurrab, Asaf Danon, Sami Alnasser, Benedict Glover, Anna Kaoutskaia, Mark Henderson, David Newman, Eugene Crystal, Dennis KoAbstractBackgroundThe choice of antithrombotic therapy for atrial fibrillation (AF) patients who have an acute coronary syndrome (ACS) or have undergone percutaneous coronary intervention (PCI) is challenging. We aimed to assess outcomes between dual antithrombotic therapy with DOACs plus an antiplatelet agent (Dual therapy) in comparison to warfarin plus two antiplatelet agents (Triple therap...
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research
There is a paucity of studies exploring whether the ischemia-bleeding trade-off could be different according to the stages of renal dysfunction in patients with atrial fibrillation (AF) who underwent percutaneous coronary intervention (PCI). Among 19598 patients in a pooled database from 3 Japanese PCI studies (CREDO-Kyoto Cohort-2, RESET, and NEXT), 1547 patients had concomitant AF. Patients were divided into 4 groups according to their renal function (Creatinine clearance [CCr]>60 mL/min: N=703, 60 ≥ CCr>30 mL/min: N=627, CCr ≤30 mL/min: N=126, Dialysis: N=91).
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research
Conditions:   Ischemic Heart Disease;   Atrial Fibrillation Interventions:   Drug: Intermittent administration of dabigatran, rivaroxaban, apixaban, or edoxaban;   Drug: Chronic administration of dabigatran, rivaroxaban, apixaban, or edoxaban Sponsor:   University of Roma La Sapienza Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Abstract BACKGROUND: Antithrombotic therapies that are optimal for atrial fibrillation (AF) patients undergoing percutaneous coronary intervention (PCI) have been studied but remain uncertain. We often encounter difficulties in choosing an appropriate antithrombotic therapy with antiplatelet agents after PCI in AF patients treated with oral anticoagulant due to a high CHADS2 score. Since there are no data on the incidences of PCI procedures in AF patients, we evaluated those incidences as well as the association between PCI and the CHADS2 score using data from the Fushimi AF Registry. METHODS: The Fushimi AF ...
Source: Journal of Cardiology - Category: Cardiology Authors: Tags: J Cardiol Source Type: research
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