Chest
Original ResearchThrombosisIncreased Major Bleeding Complications Related to Triple Antithrombotic Therapy Usage in Patients With Atrial Fibrillation Undergoing Percutaneous Coronary Artery Stenting
Section snippets
Materials and Methods
A retrospective analysis of our computerized database including all patients who were discharged from our hospital after PCI-S between January 2002 and December 2006 was performed. All AF patients with indication for OAC16 who had undergone PCI-S and belonged to our local patient catchment area (a population of 226,000) were included in the analysis.
We recorded clinical and demographic characteristics of the patients, stroke risk factors, and antithrombotic therapy use before percutaneous
Results
We identified 104 patients with AF who had undergone PCI-S over the study period (Table 1). Of the 104 study patients, only 7 patients had been included in our earlier report8 on mortality and outcomes in AF patients undergoing PCI. Median follow-up was 12 months (IQR, 10 to 12 months). All patients were followed up for at least 6 months, although 1-year follow-up was completed in 68% of the study population. The study population was elderly, with a high prevalence of comorbidities. The
Discussion
The present study has the following major findings in regard to bleeding in our AF patients undergoing PCI-S: (1) a high incidence of short-term and long-term major bleeding complications; (2) the identification of different predictors of major bleeding according to the time from the PCI-S: GP IIb/IIIa inhibitor use and the presence of multivessel/left main artery disease were independent predictors of EMB, while TT regimen and EMB were independent predictors of LMB; and (3) a high complexity
Conclusion
This study shows that AF patients with indication for OAC who undergo PCI-S represent a complex population with multiple comorbidities and a high rate of short-term and long-term major bleeding complications. Moreover, different predictors of major bleeding according to the time from the PCI-S were identified, being GP IIb/IIIa inhibitors and TT use being the main factors implicated in EMB and LMB, respectively. Although TT may theoretically represent the best antithrombotic therapy option for
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2018, Progress in Cardiovascular DiseasesCitation Excerpt :There was a minor, but statistically insignificant, increase in MACE events in the TT group (25.5% vs 21%; p = NS) compared with the non-TT group. If a difference does exist, it is most likely to be of modest clinical relevance given that a significant difference was not observed.15 Sarafoff et al. evaluate 515 patients with indications for OAC undergoing stenting with DES.16
The authors have no conflicts of interest to disclose.
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