دورية أكاديمية
Outcomes of anticoagulated patients with atrial fibrillation treated with or without antiplatelet therapy - A pooled analysis from the PREFER in AF and PREFER in AF PROLONGATON registries
| العنوان: | Outcomes of anticoagulated patients with atrial fibrillation treated with or without antiplatelet therapy - A pooled analysis from the PREFER in AF and PREFER in AF PROLONGATON registries |
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| المؤلفون: | Patti, Giuseppe, Pecen, Ladislav, Lucerna, Markus, Huber, Kurt, Rohla, Miklos, Renda, Giulia, Siller-Matula, Jolanta, Schnabel, Renate B., Cemin, Roberto, Kirchhof, Paulus, De Caterina, Raffaele |
| المساهمون: | Patti, Giuseppe, Pecen, Ladislav, Lucerna, Marku, Huber, Kurt, Rohla, Miklo, Renda, Giulia, Siller-Matula, Jolanta, Schnabel, Renate B., Cemin, Roberto, Kirchhof, Paulu, De Caterina, Raffaele |
| سنة النشر: | 2018 |
| المجموعة: | ARUd'A - Archivio Istituzionale della ricerca dell'università Chieti-Pescara (IRIS) |
| مصطلحات موضوعية: | Anticoagulant, Antiplatelet, Atrial fibrillation, Bleeding, Coronary artery disease, Major adverse cardiac event, Net clinical benefit, Aged, 80 and over, Female, Hemorrhage, Human, Male, Observational Studies as Topic, Platelet Aggregation Inhibitor, Prospective Studie, Treatment Outcome, Registrie, Cardiology and Cardiovascular Medicine |
| الوصف: | Background: Evidence on whether antiPLT added to OACs is of advantage in atrial fibrillation (AF) patients with concomitant stable coronary artery disease (CAD) is limited. We evaluated clinical outcomes with oral anticoagulant (OAC) monotherapy vs antiplatelet therapy (antiPLT) plus OAC in patients with AF and stable CAD. Methods: Data on 1058 AF patients on OACs and history (>1 year) of myocardial infarction or coronary stenting were pooled from the PREFER-in-AF and PREFER-in-AF PROLONGATION registries. We primarily compared the 1-year incidence of a net composite endpoint (primary endpoint), including acute coronary syndrome and major bleeding, with or without antiPLT. Results: The incidence of the primary net composite endpoint was significantly higher in patients receiving OACs + antiPLT (N = 348) vs OACs alone (N = 710): 7.9 vs 4.2 per 100 patients/year; adjusted OR [95% CI] 1.84 [1.01-3.37]; p = 0.048. Among the components of the primary endpoint, the greatest relative difference was found for major bleeding (OR [95% CI] 2.28 [95% CI 1.00-5.19]), and especially life-threatening or non-gastrointestinal bleeding. The net clinical outcome with OACs + antiPLT was poorer irrespective of the type of CAD (previous infarction or coronary stenting), the type of stent (bare metal or drug-eluting) or the type of OAC (vitamin K antagonist or non-vitamin K antagonist OAC). Conclusions: Among patients with AF and stable CAD >1-year after the index event, the addition of antiPLT to OAC does not apparently provide added protection against coronary events, but increases major bleeding. OAC monotherapy should thus be considered the antithrombotic therapy of choice for such patients. |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | STAMPA |
| اللغة: | English |
| العلاقة: | info:eu-repo/semantics/altIdentifier/pmid/30220376; info:eu-repo/semantics/altIdentifier/wos/WOS:000444609000036; volume:270; firstpage:160; lastpage:166; numberofpages:7; journal:INTERNATIONAL JOURNAL OF CARDIOLOGY; http://hdl.handle.net/11564/701183Test; info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85049303134; https://www.sciencedirect.com/science/article/pii/S0167527318324495Test |
| DOI: | 10.1016/j.ijcard.2018.06.098 |
| الإتاحة: | https://doi.org/10.1016/j.ijcard.2018.06.098Test http://hdl.handle.net/11564/701183Test https://www.sciencedirect.com/science/article/pii/S0167527318324495Test |
| حقوق: | info:eu-repo/semantics/closedAccess |
| رقم الانضمام: | edsbas.AEEF8207 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1016/j.ijcard.2018.06.098 |
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