Triple anticoagulation therapy in patients with atrial fibrillation undergoing percutaneous coronary intervention : real life assessment

2016
journal article
article
15
dc.abstract.enIntroduction: Triple anticoagulation therapy (TT), comprising dual antiplatelet therapy (DAPT) and oral anticoagulation (OAC), is essential in atrial fibrillation (AF) patients after percutaneous coronary intervention (PCI), but it increases the bleeding risk. Aim: To assess TT models, in- and out-hospital bleeding and thromboembolic complications, and TT alterations. Material and methods: During 12 months, consecutive AF post-PCI patients were scheduled for TT. Alterations in TT and thromboembolic events (death, myocardial infarction, ischemic stroke, in-stent thrombosis, peripheral embolization) were recorded. Major, non-major and minor bleeding episodes were assessed. Results: One hundred and thirty-six out of 3171 patients, aged 73.0 ±8.4 years (90 male), were included. Intra-hospitally, thrombotic events occurred in 9 (6.6%), while bleeding events occurred in 71 (52.2%) patients. Access-site hematoma and blood transfusions during in-hospital stay predisposed physicians to heparin administration as part of TT on discharge (p = 0.018 and p = 0.033 respectively). Eventually, DAPT plus warfarin or plus novel oral anticoagulant (NOAC) or plus low molecular weight heparin was prescribed in 72 (52.9%), 53 (39%), and 11 (8.1%) patients, respectively. HAS-BLED and CHA2DS2-VASc scores were similar between subgroups (p = 0.63 and p = 0.64 respectively). During 10.2 ±4.2 months of follow-up, 11 (8.1%) deaths, and 9 (6.6%) non-fatal thromboembolic events occurred. Bleeding events occurred in 45 (34.6%) patients, including 14 (10.3%) major. TT was the only factor associated with increased risk of major bleeding (18.6% vs. 4.2%, p = 0.008). Early termination of any TT component, which concerned 59 (45.4%) patients, did not increase the risk of thromboembolic events (p = 0.89). Conclusions: Our study indicates that TT is associated with high mortality and bleeding rates in a relatively short period of time. Discontinuation of any TT drug did not increase the thromboembolic event rate, while it was associated with reduced risk of major bleeding.pl
dc.affiliationWydział Lekarski : Instytut Kardiologiipl
dc.cm.date2020-01-07
dc.cm.id79805
dc.contributor.authorBogacki, Pawełpl
dc.contributor.authorKabłak-Ziembicka, Anna - 129937 pl
dc.contributor.authorBryniarski, Krzysztof - 212152 pl
dc.contributor.authorWrotniak, Leszekpl
dc.contributor.authorOstrowska-Kaim, Elżbietapl
dc.contributor.authorŻmudka, Krzysztof - 133948 pl
dc.contributor.authorPrzewłocki, Tadeusz - 133225 pl
dc.date.accessioned2020-01-17T09:11:54Z
dc.date.available2020-01-17T09:11:54Z
dc.date.issued2016pl
dc.date.openaccess0
dc.description.accesstimew momencie opublikowania
dc.description.number4 (46)pl
dc.description.physical303-313pl
dc.description.points15pl
dc.description.versionostateczna wersja wydawcy
dc.description.volume12pl
dc.identifier.doi10.5114/aic.2016.63629pl
dc.identifier.eissn1897-4295pl
dc.identifier.issn1734-9338pl
dc.identifier.projectROD UJ / OPpl
dc.identifier.urihttps://ruj.uj.edu.pl/xmlui/handle/item/139136
dc.languageengpl
dc.language.containerengpl
dc.rightsUdzielam licencji. Uznanie autorstwa - Użycie niekomercyjne - Na tych samych warunkach 4.0 Międzynarodowa*
dc.rights.licenceCC-BY-NC-SA
dc.rights.urihttp://creativecommons.org/licenses/by-nc-sa/4.0/legalcode.pl*
dc.share.typeotwarte czasopismo
dc.source.integratorfalse
dc.subject.enatrial fibrillationpl
dc.subject.encardiovascular eventspl
dc.subject.entriple anticoagulant therapypl
dc.subject.encoronary percutaneous interventionpl
dc.subject.enbleeding and thromboembolic complicationspl
dc.subtypeArticlepl
dc.titleTriple anticoagulation therapy in patients with atrial fibrillation undergoing percutaneous coronary intervention : real life assessmentpl
dc.title.journalPostępy w Kardiologii Interwencyjnejpl
dc.typeJournalArticlepl
dspace.entity.typePublication
dc.abstract.enpl
Introduction: Triple anticoagulation therapy (TT), comprising dual antiplatelet therapy (DAPT) and oral anticoagulation (OAC), is essential in atrial fibrillation (AF) patients after percutaneous coronary intervention (PCI), but it increases the bleeding risk. Aim: To assess TT models, in- and out-hospital bleeding and thromboembolic complications, and TT alterations. Material and methods: During 12 months, consecutive AF post-PCI patients were scheduled for TT. Alterations in TT and thromboembolic events (death, myocardial infarction, ischemic stroke, in-stent thrombosis, peripheral embolization) were recorded. Major, non-major and minor bleeding episodes were assessed. Results: One hundred and thirty-six out of 3171 patients, aged 73.0 ±8.4 years (90 male), were included. Intra-hospitally, thrombotic events occurred in 9 (6.6%), while bleeding events occurred in 71 (52.2%) patients. Access-site hematoma and blood transfusions during in-hospital stay predisposed physicians to heparin administration as part of TT on discharge (p = 0.018 and p = 0.033 respectively). Eventually, DAPT plus warfarin or plus novel oral anticoagulant (NOAC) or plus low molecular weight heparin was prescribed in 72 (52.9%), 53 (39%), and 11 (8.1%) patients, respectively. HAS-BLED and CHA2DS2-VASc scores were similar between subgroups (p = 0.63 and p = 0.64 respectively). During 10.2 ±4.2 months of follow-up, 11 (8.1%) deaths, and 9 (6.6%) non-fatal thromboembolic events occurred. Bleeding events occurred in 45 (34.6%) patients, including 14 (10.3%) major. TT was the only factor associated with increased risk of major bleeding (18.6% vs. 4.2%, p = 0.008). Early termination of any TT component, which concerned 59 (45.4%) patients, did not increase the risk of thromboembolic events (p = 0.89). Conclusions: Our study indicates that TT is associated with high mortality and bleeding rates in a relatively short period of time. Discontinuation of any TT drug did not increase the thromboembolic event rate, while it was associated with reduced risk of major bleeding.
dc.affiliationpl
Wydział Lekarski : Instytut Kardiologii
dc.cm.date
2020-01-07
dc.cm.id
79805
dc.contributor.authorpl
Bogacki, Paweł
dc.contributor.authorpl
Kabłak-Ziembicka, Anna - 129937
dc.contributor.authorpl
Bryniarski, Krzysztof - 212152
dc.contributor.authorpl
Wrotniak, Leszek
dc.contributor.authorpl
Ostrowska-Kaim, Elżbieta
dc.contributor.authorpl
Żmudka, Krzysztof - 133948
dc.contributor.authorpl
Przewłocki, Tadeusz - 133225
dc.date.accessioned
2020-01-17T09:11:54Z
dc.date.available
2020-01-17T09:11:54Z
dc.date.issuedpl
2016
dc.date.openaccess
0
dc.description.accesstime
w momencie opublikowania
dc.description.numberpl
4 (46)
dc.description.physicalpl
303-313
dc.description.pointspl
15
dc.description.version
ostateczna wersja wydawcy
dc.description.volumepl
12
dc.identifier.doipl
10.5114/aic.2016.63629
dc.identifier.eissnpl
1897-4295
dc.identifier.issnpl
1734-9338
dc.identifier.projectpl
ROD UJ / OP
dc.identifier.uri
https://ruj.uj.edu.pl/xmlui/handle/item/139136
dc.languagepl
eng
dc.language.containerpl
eng
dc.rights*
Udzielam licencji. Uznanie autorstwa - Użycie niekomercyjne - Na tych samych warunkach 4.0 Międzynarodowa
dc.rights.licence
CC-BY-NC-SA
dc.rights.uri*
http://creativecommons.org/licenses/by-nc-sa/4.0/legalcode.pl
dc.share.type
otwarte czasopismo
dc.source.integrator
false
dc.subject.enpl
atrial fibrillation
dc.subject.enpl
cardiovascular events
dc.subject.enpl
triple anticoagulant therapy
dc.subject.enpl
coronary percutaneous intervention
dc.subject.enpl
bleeding and thromboembolic complications
dc.subtypepl
Article
dc.titlepl
Triple anticoagulation therapy in patients with atrial fibrillation undergoing percutaneous coronary intervention : real life assessment
dc.title.journalpl
Postępy w Kardiologii Interwencyjnej
dc.typepl
JournalArticle
dspace.entity.type
Publication
Affiliations

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