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

研究成果: Article

15 引用 (Scopus)

抄録

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.

元の言語English
ページ(範囲)197-202
ページ数6
ジャーナルJournal of cardiology
65
発行部数3
DOI
出版物ステータスPublished - 01-03-2015

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Atrial Fibrillation
Coronary Vessels
Hemorrhage
Warfarin
Therapeutics
Myocardial Infarction
Platelet Aggregation Inhibitors
Cerebral Infarction
Proportional Hazards Models
Stents
Cause of Death
Confidence Intervals

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

これを引用

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. / Major bleeding complications related to combined antithrombotic therapy in atrial fibrillation patients 12 months after coronary artery stenting. :: Journal of cardiology. 2015 ; 巻 65, 番号 3. pp. 197-202.
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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.",
author = "Hideki Kawai and Eiichi Watanabe and Mayumi Yamamoto and Hiroto Harigaya and Kan Sano and Hidemaro Takatsu and Takashi Muramatsu and Hiroyuki Naruse and Yoshihiro Sobue and Sadako Motoyama and Masayoshi Sarai and Hiroshi Takahashi and Tomoharu Arakawa and Shino Kan and Atsushi Sugiura and Toyoaki Murohara and Yukio Ozaki",
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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, 巻. 65, 番号 3, pp. 197-202. https://doi.org/10.1016/j.jjcc.2014.08.013

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.

:: Journal of cardiology, 巻 65, 番号 3, 01.03.2015, p. 197-202.

研究成果: 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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EP - 202

JO - Journal of Cardiology

JF - Journal of Cardiology

SN - 0914-5087

IS - 3

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