An update on antithrombotic therapy in atrial fibrillation patients in long-term ambulatory setting after percutaneous coronary intervention: where do we go from here?

Marazzato, Jacopo; Verdecchia, Paolo; Golino, Michele; Blasi, F.; Crippa, Matteo; Ponti, Roberto De; Angeli, Fabio

doi:10.1080/14656566.2021.1937119

Cited by 2 publications

(1 citation statement)

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“…Despite the technical evolution of PCI, there are still concerns about stent thrombosis or recurrent ischemic cardiovascular events with a shorter duration or fewer numbers of antiplatelet agents [28,29]. Patient characteristics, such as comorbidities associated with a higher risk of thrombotic/ischemic events, PCI due to ACS, residual untreated coronary lesions, and the complexity of PCI lesions, should be considered when reducing the intensiveness of antithrombotic therapy [30]. In our study, DOAC monotherapy was not associated with increased acute coronary events or cardiovascular death, without a significant interaction with the acute MI subgroup.…”

Section: Clinical Implicationmentioning

confidence: 99%

Effectiveness of Early Direct Oral Anticoagulant Monotherapy within One Year of Coronary Stent Implantation in Patients with Atrial Fibrillation: A Nationwide Population-Based Study

Hwang,

Park,

Kim

et al. 2023

JCM

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We evaluated the effectiveness of early direct oral anticoagulant (DOAC) monotherapy within one year after percutaneous coronary intervention (PCI) in patients with atrial fibrillation (AF) using Korean National Health Insurance Service data. AF patients who underwent PCI were included and divided into the DOAC monotherapy group and the combination therapy group (DOAC with an antiplatelet agent) based on the medications used at 6 months after PCI. A major adverse cardiovascular event (MACE) was defined as a composite of cardiovascular death, acute myocardial infarction (AMI), stroke, or systemic thromboembolic event between 6 and 12 months after PCI. In the overall study population, the DOAC dose reduction rate was high in both the monotherapy group (70.8%) and the combination therapy group (79.1%). After propensity score matching, the MACE incidence was not significantly different between the two groups (hazard ratio [HR] 1.42 [0.90–2.24]). The numerical trend for higher MACE in the monotherapy group was mainly driven by the difference in stroke incidence (HR 1.84 [0.97–3.46]). All-cause death (HR 1.29 [0.61–2.74] or the incidence of major bleeding (HR 1.07 [0.49–2.35]) results were similar in the two groups. In conclusion, early DOAC monotherapy was not significantly associated with MACE risk between 6 and 12 months after PCI.

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Section: Clinical Implicationmentioning

confidence: 99%