Major bleeding complications related to combined antithrombotic therapy in atrial fibrillation patients 12 months after coronary artery stenting

Hideki Kawai, Eiichi Watanabe, Mayumi Yamamoto, Hiroto Harigaya, Kan Sano, Hidemaro Takatsu, Takashi Muramatsu, Hiroyuki Naruse, Yoshihiro Sobue, Sadako Motoyama, Masayoshi Sarai, Hiroshi Takahashi, Tomoharu Arakawa, Shino Kan, Atsushi Sugiura, Toyoaki Murohara, Yukio Ozaki

Research output: Contribution to journalArticle

15 Citations (Scopus)

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 languageEnglish
Pages (from-to)197-202
Number of pages6
JournalJournal of cardiology
Volume65
Issue number3
DOIs
Publication statusPublished - 01-03-2015

    Fingerprint

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Kawai, H., Watanabe, E., Yamamoto, M., Harigaya, H., Sano, K., Takatsu, H., Muramatsu, T., Naruse, H., Sobue, Y., Motoyama, S., Sarai, M., Takahashi, H., Arakawa, T., Kan, S., Sugiura, A., Murohara, T., & Ozaki, Y. (2015). Major bleeding complications related to combined antithrombotic therapy in atrial fibrillation patients 12 months after coronary artery stenting. Journal of cardiology, 65(3), 197-202. https://doi.org/10.1016/j.jjcc.2014.08.013