Abstract
Background and purpose: Many patients with atrial fibrillation (AF) and coronary artery stent deployment are given both antiplatelet drug and warfarin. Little information is available as to the relationship between the antithrombotic therapies in the late phase after stenting and the clinical outcomes of these patients. We examined the clinical outcomes of AF patients 12 months after coronary artery stenting. Methods: We retrospectively examined 146 patients and classified them into three groups according to the antithrombotic therapies [dual antiplatelet therapy (DAPT), single antiplatelet therapy (SAPT) plus warfarin, and DAPT plus warfarin] 12 months after stenting. We defined the primary endpoint as Thrombolysis in Myocardial Infarction major bleeding and the secondary endpoint as a composite of adverse events (CAE: all-cause death, nonfatal myocardial infarction, intracranial bleeding, and cerebral infarction). Results: During a median follow-up of 37 months, major bleeding and CAE were observed in 14 (9.6%) and 46 (31.5%) patients, respectively. DAPT plus warfarin was an independent risk factor for major bleeding in a multivariate Cox hazard regression model after adjustment for age, gender, and the type of AF (hazard ratio: 4.20; 95% confidence interval: 1.13-17.27; p=. 0.033). No significant clinical variables were found for CAE. Conclusions: Prolonged use of DAPT with warfarin significantly increases the risk of major bleeding in AF patients after coronary artery stenting. Individualized antithrombotic treatment is required in these patients to prevent major bleeding.
| Original language | English |
|---|---|
| Pages (from-to) | 197-202 |
| Number of pages | 6 |
| Journal | Journal of cardiology |
| Volume | 65 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - 01-03-2015 |
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All Science Journal Classification (ASJC) codes
- Cardiology and Cardiovascular Medicine
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Major bleeding complications related to combined antithrombotic therapy in atrial fibrillation patients 12 months after coronary artery stenting. / Kawai, Hideki; Watanabe, Eiichi; Yamamoto, Mayumi; Harigaya, Hiroto; Sano, Kan; Takatsu, Hidemaro; Muramatsu, Takashi; Naruse, Hiroyuki; Sobue, Yoshihiro; Motoyama, Sadako; Sarai, Masayoshi; Takahashi, Hiroshi; Arakawa, Tomoharu; Kan, Shino; Sugiura, Atsushi; Murohara, Toyoaki; Ozaki, Yukio.
In: Journal of cardiology, Vol. 65, No. 3, 01.03.2015, p. 197-202.Research output: Contribution to journal › Article
TY - JOUR
T1 - Major bleeding complications related to combined antithrombotic therapy in atrial fibrillation patients 12 months after coronary artery stenting
AU - Kawai, Hideki
AU - Watanabe, Eiichi
AU - Yamamoto, Mayumi
AU - Harigaya, Hiroto
AU - Sano, Kan
AU - Takatsu, Hidemaro
AU - Muramatsu, Takashi
AU - Naruse, Hiroyuki
AU - Sobue, Yoshihiro
AU - Motoyama, Sadako
AU - Sarai, Masayoshi
AU - Takahashi, Hiroshi
AU - Arakawa, Tomoharu
AU - Kan, Shino
AU - Sugiura, Atsushi
AU - Murohara, Toyoaki
AU - Ozaki, Yukio
PY - 2015/3/1
Y1 - 2015/3/1
N2 - Background and purpose: Many patients with atrial fibrillation (AF) and coronary artery stent deployment are given both antiplatelet drug and warfarin. Little information is available as to the relationship between the antithrombotic therapies in the late phase after stenting and the clinical outcomes of these patients. We examined the clinical outcomes of AF patients 12 months after coronary artery stenting. Methods: We retrospectively examined 146 patients and classified them into three groups according to the antithrombotic therapies [dual antiplatelet therapy (DAPT), single antiplatelet therapy (SAPT) plus warfarin, and DAPT plus warfarin] 12 months after stenting. We defined the primary endpoint as Thrombolysis in Myocardial Infarction major bleeding and the secondary endpoint as a composite of adverse events (CAE: all-cause death, nonfatal myocardial infarction, intracranial bleeding, and cerebral infarction). Results: During a median follow-up of 37 months, major bleeding and CAE were observed in 14 (9.6%) and 46 (31.5%) patients, respectively. DAPT plus warfarin was an independent risk factor for major bleeding in a multivariate Cox hazard regression model after adjustment for age, gender, and the type of AF (hazard ratio: 4.20; 95% confidence interval: 1.13-17.27; p=. 0.033). No significant clinical variables were found for CAE. Conclusions: Prolonged use of DAPT with warfarin significantly increases the risk of major bleeding in AF patients after coronary artery stenting. Individualized antithrombotic treatment is required in these patients to prevent major bleeding.
AB - Background and purpose: Many patients with atrial fibrillation (AF) and coronary artery stent deployment are given both antiplatelet drug and warfarin. Little information is available as to the relationship between the antithrombotic therapies in the late phase after stenting and the clinical outcomes of these patients. We examined the clinical outcomes of AF patients 12 months after coronary artery stenting. Methods: We retrospectively examined 146 patients and classified them into three groups according to the antithrombotic therapies [dual antiplatelet therapy (DAPT), single antiplatelet therapy (SAPT) plus warfarin, and DAPT plus warfarin] 12 months after stenting. We defined the primary endpoint as Thrombolysis in Myocardial Infarction major bleeding and the secondary endpoint as a composite of adverse events (CAE: all-cause death, nonfatal myocardial infarction, intracranial bleeding, and cerebral infarction). Results: During a median follow-up of 37 months, major bleeding and CAE were observed in 14 (9.6%) and 46 (31.5%) patients, respectively. DAPT plus warfarin was an independent risk factor for major bleeding in a multivariate Cox hazard regression model after adjustment for age, gender, and the type of AF (hazard ratio: 4.20; 95% confidence interval: 1.13-17.27; p=. 0.033). No significant clinical variables were found for CAE. Conclusions: Prolonged use of DAPT with warfarin significantly increases the risk of major bleeding in AF patients after coronary artery stenting. Individualized antithrombotic treatment is required in these patients to prevent major bleeding.
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U2 - 10.1016/j.jjcc.2014.08.013
DO - 10.1016/j.jjcc.2014.08.013
M3 - Article
C2 - 25266323
AN - SCOPUS:84924336812
VL - 65
SP - 197
EP - 202
JO - Journal of Cardiology
JF - Journal of Cardiology
SN - 0914-5087
IS - 3
ER -