Bare-Metal vs. Drug-Eluting Stents in Patients With Atrial Fibrillation Undergoing Percutaneous Coronary Intervention

Kiviniemi, Tuomas; Puurunen, Marja; Schlitt, Axel; Rubboli, Andrea; Karjalainen, Pasi P.; Nammas, Wail; Kirchhof, Paulus; Biancari, Fausto; Lip, Gregory Y.H.; Airaksinen, Juhani

doi:10.1253/circj.cj-14-0792

Cited by 21 publications

(13 citation statements)

References 35 publications

(19 reference statements)

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“…Furthermore, the incidence of stroke (b) was relatively higher in patients with atrial fibrillation (AF) than in those without. However, the incidence of cardiovascular death (c) and MI (d) were similar in both AF and non-AF groups Comparison of mid-term outcomes between patients with and without atrial fibrillation… who underwent PCI in the first-generation DES era [17]. In the present study, the MACE rate (including TVR) was 15.3 %.…”

Section: Discussionmentioning

confidence: 48%

Comparison of mid-term outcomes between patients with and without atrial fibrillation undergoing coronary stenting in the second-generation drug-eluting stent era: from the SHINANO registry

Miura

Miyashita

Motoki

et al. 2016

Cardiovasc Interv and Ther

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Little is known about the mid-term outcomes of patients with atrial fibrillation (AF) who undergo coronary stenting in the second-generation drug-eluting stent (DES) era. We evaluated the 1-year outcomes of AF patients undergoing percutaneous coronary intervention (PCI) with second-generation DES. This retrospective cohort analysis used integrated data from the SHINANO registry, a prospective observational multicenter cohort study, which enrolled 1923 consecutive patients undergoing PCI for any coronary artery disease. We retrospectively recruited 917 of these patients (mean age, 71.3 ± 10.0 years; male, 77 %) who received PCI with 2nd generation DES. The primary endpoint was net adverse clinical events (NACE: cardiac death, stroke, MI, stent thrombosis, and major bleeding) at 1 year. The secondary endpoints were major adverse cardiovascular events (MACE: cardiac death, stroke, and MI), stroke, MI, and major bleeding at 1 year. One-year follow-up was completed in 871 (94.9 %) patients, of whom 85 had AF. The incidence of NACE (15.4 vs. 7.3 %, P = 0.008), MACE (10.6 vs. 5.4 %, P = 0.047), and major bleeding (6.0 vs. 2.3 %, P = 0.049) were all significantly higher in AF compared to non-AF patients. On multivariate analysis, AF was an independent predictor of NACE (HR 2.32, 95 % CI 1.24-4.34, P = 0.008). In the second-generation DES era, patients with AF undergoing PCI still have a poorer prognosis, with more thrombotic and bleeding events, than those without AF. More attention should be paid to the thrombotic and bleeding risk in AF patients undergoing PCI.

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Section: Discussionmentioning

confidence: 48%

Comparison of mid-term outcomes between patients with and without atrial fibrillation undergoing coronary stenting in the second-generation drug-eluting stent era: from the SHINANO registry

Miura

Miyashita

Motoki

et al. 2016

Cardiovasc Interv and Ther

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“…Details of the study have been published elsewhere [7][8][9][10]. At each participating center, patients were treated according to local policies, and were followed up for 12 months (phone call at 3, 6 and 12 months and when needed by assessment of patient records in the hospitals and in health centers of catchment areas).…”

Section: Study Populationmentioning

confidence: 99%

“…At each participating center, patients were treated according to local policies, and were followed up for 12 months (phone call at 3, 6 and 12 months and when needed by assessment of patient records in the hospitals and in health centers of catchment areas). Each event was adjudicated according to the pre-specified definitions for myocardial infarction, target vessel revascularization, stent thrombosis transient ischemic attack and stroke [7][8][9][10]. Bleeding events were centrally adjudicated based on the patient record data on case report forms.…”

Section: Study Populationmentioning

confidence: 99%

Bridging therapy with low molecular weight heparin in patients with atrial fibrillation undergoing percutaneous coronary intervention with stent implantation: The AFCAS study

Kiviniemi

Airaksinen

Rubboli

et al. 2015

International Journal of Cardiology

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“…This result was different from the finding from other studies that revealed a striking increase in the use of triple antithrombotic therapy at discharge after the 2010 ESC guidelines on AF. [710121314] The present study revealed that the AF patients undergoing coronary stenting were less likely to receive guideline-recommended triple antithrombotic therapy, especially for patients with a high HAS-BLED score and even for high thromboembolic risk patients at low bleeding risk.…”

Section: Discussionmentioning

confidence: 75%

Current Use of Oral Anticoagulants and Prognostic Analysis in Patients with Atrial Fibrillation Undergoing Coronary Stenting

Zhai

Liu

Dong

et al. 2017

Chinese Medical Journal

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Background:It is currently believed that triple oral antithrombotic therapy in patients with atrial fibrillation (AF) after percutaneous coronary intervention (PCI) should be recommended if there are no contraindications. However, selecting triple therapy for AF patients undergoing PCI is still challenging when bleeding risk is considered. This study aimed to investigate the current use of oral anticoagulants (Vitamin K antagonists [VKA]) and perform prognostic analysis in real-world patients with AF undergoing coronary stenting.Methods:A total of 276 consecutive coronary artery disease (CAD) patients with or without AF undergoing coronary stenting were retrospectively evaluated and analyzed. The univariate and multivariate analyses were conducted to explore the current use of VKA and prognosis of patients with AF undergoing coronary stenting. The primary end-point was composite of all-cause death, nonfatal recurrent myocardial infarction, stroke, serious bleeding events, unplanned repeat revascularization, and worsening heart failure at 12-month follow-up after coronary stenting.Results:AF patients undergoing coronary stenting have more clinical concomitant diseases. Only 9.0% AF patients after coronary stenting received triple antithrombotic therapy (VKA, aspirin, and clopidogrel) at discharge. AF was independently associated with increased risk of the 12-month composite end-points (relative risk = 5.732, 95% confidence interval 1.786–18.396, P = 0.003).Conclusions:In real-life AF patients undergoing coronary stenting, guideline-recommended VKA was less used. AF patients had adjusted worse prognosis during 12-month follow-up after discharge. It is of utmost importance to improve the current status of oral anticoagulants use.

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Bare-Metal vs. Drug-Eluting Stents in Patients With Atrial Fibrillation Undergoing Percutaneous Coronary Intervention

Cited by 21 publications

References 35 publications

Comparison of mid-term outcomes between patients with and without atrial fibrillation undergoing coronary stenting in the second-generation drug-eluting stent era: from the SHINANO registry

Comparison of mid-term outcomes between patients with and without atrial fibrillation undergoing coronary stenting in the second-generation drug-eluting stent era: from the SHINANO registry

Bridging therapy with low molecular weight heparin in patients with atrial fibrillation undergoing percutaneous coronary intervention with stent implantation: The AFCAS study

Current Use of Oral Anticoagulants and Prognostic Analysis in Patients with Atrial Fibrillation Undergoing Coronary Stenting

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