Temporal Trends in Antithrombotic Therapy for Patients With Atrial Fibrillation Undergoing Percutaneous Coronary...

Area of Science:

• Cardiology
• Interventional Cardiology
• Pharmacology

Background:

• Recent guideline revisions by major cardiovascular societies (Japanese Circulation Society, AHA/ACC, ESC) have updated antithrombotic strategies for atrial fibrillation (AF) patients undergoing percutaneous coronary intervention (PCI).
• The real-world implementation and adoption of these updated guidelines in clinical practice remain unclear.

Purpose of the Study:

• To assess the extent to which Japanese interventional cardiologists have implemented revised antithrombotic strategies for AF patients undergoing PCI.
• To track changes in antithrombotic therapy practices over time in response to guideline updates.

Main Methods:

• A survey was conducted every two years from 2014 to 2022 across 14 cardiovascular centers in Japan.
• The survey focused on the status of antithrombotic therapy in patients with AF undergoing PCI.

Main Results:

• Primary use of drug-eluting stents increased from 10% (2014) to 95-100% (2018).
• Use of direct oral anticoagulants rose from 15% (2014) to 100% (2018).
• Triple therapy duration increased significantly post-2018 for both acute and chronic coronary syndromes, with a common transition to anticoagulation monotherapy at 1 year post-PCI since 2020.

Conclusions:

• Japanese interventional cardiologists have successfully updated their treatment strategies for AF patients undergoing PCI.
• Clinical practice has largely aligned with revised international and national practice guidelines regarding antithrombotic therapy.