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Post-discharge antithrombotic management and clinical outcomes of patients with new-onset or pre-existing atrial fibrillation and acute coronary syndromes undergoing coronary stenting: Follow-up data of the MATADOR-PCI study.
- Source :
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European journal of internal medicine [Eur J Intern Med] 2021 Jun; Vol. 88, pp. 28-34. Date of Electronic Publication: 2021 Apr 08. - Publication Year :
- 2021
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Abstract
- Background: . Patients with concomitant atrial fibrillation (AF) and acute coronary syndromes (ACS) do not seem to receive proper antithrombotic therapies and present high rates of adverse clinical events.<br />Methods: . We analyzed the follow-up data of the prospective, nationwide MATADOR-PCI registry. We assessed the use of antithrombotic strategies and the incidence of major adverse cardiovascular events (MACE) and net adverse clinical events (NACE) at 6 months, in patients with new-onset or pre-existing AF admitted for ACS and treated with percutaneous coronary intervention (PCI).<br />Results: . Out of the 588 patients enrolled in the registry and discharged alive (287 with pre-existing and 301 with new-onset AF), data at 6 months were obtained for 579 (98.5%) patients. Compared to hospital discharge, the rate of triple antithrombotic therapy was significantly reduced (from 76.4% to 23.6% and from 53.8% to 23.6%; both p<0.0001) while dual antithrombotic therapy (DAT) increased (from 11.8% to 56.3% and from 5.8% to 30.9%; both p<0.0001) at follow-up, in patients with pre-existing and new-onset AF, respectively. Among patients with a class IA indication to receive oral anticoagulation therapy (OAT), it was prescribed in 91% and 88% of patients with pre-existing and 64% and 62% of new-onset AF, at discharge and follow-up, respectively. At 6 months from discharge the overall rate of MACE was 8.4% and 7.6% (p=0.75), while NACE occurred in 10.8% vs 10.0% (p=0.74) of patients with pre-existing or new-onset AF, respectively.<br />Conclusions: . At follow-up, DAT was the most used antithrombotic strategy for both patients with pre-existing and new-onset AF with concomitant ACS. These two groups of patients presented comparable rates of MACE and NACE at 6 months.<br /> (Copyright © 2021. Published by Elsevier B.V.)
- Subjects :
- Aftercare
Anticoagulants therapeutic use
Fibrinolytic Agents therapeutic use
Follow-Up Studies
Humans
Patient Discharge
Platelet Aggregation Inhibitors therapeutic use
Prospective Studies
Treatment Outcome
Acute Coronary Syndrome complications
Acute Coronary Syndrome drug therapy
Acute Coronary Syndrome epidemiology
Atrial Fibrillation complications
Atrial Fibrillation drug therapy
Atrial Fibrillation epidemiology
Percutaneous Coronary Intervention
Subjects
Details
- Language :
- English
- ISSN :
- 1879-0828
- Volume :
- 88
- Database :
- MEDLINE
- Journal :
- European journal of internal medicine
- Publication Type :
- Academic Journal
- Accession number :
- 33838988
- Full Text :
- https://doi.org/10.1016/j.ejim.2021.03.029