Τίτλος:
Trends of Antithrombotic Treatment in Atrial Fibrillation Patients Undergoing Percutaneous Coronary Intervention: Insights from the GReek-AntiPlatElet Atrial Fibrillation (GRAPE-AF) Registry
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Purpose: Patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI) are a high-risk subset of patients, whose optimal antithrombotic treatment strategy, involving a combination of anticoagulant and antiplatelet agents, has not been well defined. Our study aims to investigate contemporary “real-world” trends of antithrombotic treatment strategies in AF patients undergoing PCI, as well as identify factors affecting decision-making at hospital discharge. Methods: “Real-world” data were retrieved from the GReek-AntiPlatElet Atrial Fibrillation (GRAPE-AF) registry, a contemporary, nationwide, multicenter, observational study of AF patients undergoing PCI. Characteristics of patients discharged on triple antithrombotic therapy (TAT) or dual antithrombotic therapy (DAT) were compared in order to identify factors that could influence treatment decisions. Results: A total of 654 patients were enrolled (42% with stable coronary artery disease, 58% with acute coronary syndrome). TAT was adopted in 49.9% and DAT in 49.2% of patients at discharge. Regarding anticoagulants, the vast majority of patients (92.9%) received non-vitamin K antagonist oral anticoagulants (NOACs) and only 7.1% received vitamin K antagonists (VKAs). Dyslipidemia, insulin-dependent diabetes mellitus, prior myocardial infarction, acute coronary syndrome at presentation, and regional variations were predictive of TAT adoption, whereas the use of NOACs or ticagrelor was predictive of DAT adoption. Conclusion: Contemporary “real-world” data concerning antithrombotic treatment in AF patients undergoing PCI indicate a strong shift towards the use of NOACs instead of VKAs, along with a large subset of patients adopting an aspirin-free strategy early after index PCI, with clinical as well as treatment characteristics affecting decision-making. Trial registration: ClinicalTrials.gov Identifier: NCT03362788 (First Posted: December 5, 2017) © 2020, Springer Science+Business Media, LLC, part of Springer Nature.
Συγγραφείς:
Benetou, D.-R.
Varlamos, C.
Ktenas, D.
Tsiafoutis, I.
Koutouzis, M.
Bampali, T.
Mantis, C.
Zarifis, J.
Skalidis, E.
Aravantinos, D.
Varvarousis, D.
Lianos, I.
Kanakakis, J.
Pisimisis, E.
Ziakas, A.
Davlouros, P.
Alexopoulos, D.
on behalf of GRAPE-AF investigators
Περιοδικό:
Cardiovascular Drugs and Therapy
Λέξεις-κλειδιά:
acetylsalicylic acid; anticoagulant agent; antithrombocytic agent; antivitamin K; apixaban; clopidogrel; dabigatran; non vitamin K antagonist; prasugrel; purinergic P2Y receptor antagonist; rivaroxaban; ticagrelor; unclassified drug; anticoagulant agent; blood clotting factor 10a inhibitor; vitamin K group, acute coronary syndrome; aged; anticoagulant therapy; Article; atrial fibrillation; clinical decision making; controlled study; coronary artery disease; drug substitution; drug withdrawal; dual antiplatelet therapy; dyslipidemia; female; heart infarction; hospital discharge; human; insulin dependent diabetes mellitus; major clinical study; male; medical history; multicenter study (topic); observational study; percutaneous coronary intervention; priority journal; retrospective study; risk factor; thromboembolism; thrombosis; thrombosis prevention; atrial fibrillation; clinical trial; combination drug therapy; comorbidity; demography; middle aged; multicenter study; oral drug administration; percutaneous coronary intervention; procedures; very elderly, Administration, Oral; Aged; Aged, 80 and over; Anticoagulants; Atrial Fibrillation; Comorbidity; Drug Therapy, Combination; Dual Anti-Platelet Therapy; Factor Xa Inhibitors; Female; Humans; Male; Middle Aged; Percutaneous Coronary Intervention; Residence Characteristics; Sociodemographic Factors; Vitamin K
DOI:
10.1007/s10557-020-07090-x
