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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
28:13

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Published on: February 26, 2013

Optimal antithrombotic strategy in patients with atrial fibrillation after coronary stent implantation

Sung-Won Jang1, Tai-Ho Rho, Dong-Bin Kim

  • 1Division of Cardiology, Department of Internal Medicine, The Catholic University of Korea School of Medicine, Seoul, Korea.

Korean Circulation Journal
|November 30, 2011
PubMed

Insights

Warfarin use after percutaneous coronary intervention (PCI) in atrial fibrillation (AF) patients did not reduce major adverse cardiac events but increased major bleeding risk. Optimal antithrombotic therapy requires careful consideration in this population.

Area of Science:

  • Cardiology
  • Internal Medicine
  • Pharmacology

Background:

  • Optimal antithrombotic therapy following percutaneous coronary intervention (PCI) in patients with atrial fibrillation (AF) remains unclear.
  • Evidence on treatment strategies for AF patients undergoing PCI is limited.

Purpose of the Study:

  • To investigate the outcomes of different antithrombotic treatment strategies in AF patients after PCI.
  • To analyze the effectiveness and safety of antithrombotic regimens in this patient group.

Main Methods:

  • A cohort of 362 AF patients who underwent PCI with stent implantation between 2005 and 2007 was reviewed.
  • Clinical, demographic, procedural characteristics, stroke risk factors, and antithrombotic regimens were analyzed.
  • Kaplan-Meier survival analysis was used to assess outcomes.

Main Results:

  • Common comorbidities included hypertension (59.4%), diabetes (37.3%), and congestive heart failure (16.6%).
  • Warfarin was prescribed to 23.2% of patients at discharge.
  • Warfarin treatment was not associated with a lower risk of major adverse cardiac events (MACE) but was linked to an increased risk of major bleeding (p=0.002).

Conclusions:

  • Oral anticoagulation therapy, including warfarin, after PCI may increase hemorrhagic events in Korean AF patients.
  • The findings suggest a need for careful evaluation of antithrombotic strategies in AF patients post-PCI to balance efficacy and safety.
Abstract

Keywords:
AngioplastyAnticoagulantsAtrial fibrillationPlatelet aggregation inhibitorsStents

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