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A prospective interventional registry of short-term dual-antiplatelet treatment after implantation of drug-eluting stents in patients with atrial fibrillation requiring oral anticoagulation therapy

  • Kazunori HorieEmail author
  • Takashi Matsumoto
  • Yukiko Mizutani
  • Norio Tada
  • Norichika Osai
  • Tsuyoshi Isawa
  • Masataka Taguri
  • Shigeaki Kato
  • Taku Honda
  • Tatsushi Ootomo
  • Naoto Inoue
Original Article
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Abstract

There are limited data regarding the use of antithrombotic therapy in patients with atrial fibrillation (AF) who underwent percutaneous coronary intervention (PCI) with drug-eluting stents (DES). In this prospective interventional study, we evaluated the feasibility of short-term dual-antiplatelet therapy (DAPT) after DES implantation in AF patients treated with oral anticoagulation (OAC). The antithrombotic regimen in the present study was 1-month DAPT, followed by single-antiplatelet therapy with OAC. A total of 285 consecutive patients were enrolled between 2015 and 2017. The mean CHA2DS2-VASc score was 3.91 ± 1.51. The duration of DAPT was 28.5 ± 11.5 days. At 1-year follow-up, serious bleeding complications, defined as Bleeding Academic Research Consortium type ≥ 2, were observed in 27 patients (9.5%). Multivariate analysis showed that previous history of bleeding episodes (P = 0.009) and continuation of aspirin (P = 0.003) were independent predictors for the serious bleeding complications. High ORBIT (P = 0.008) and PRECISE-DAPT (P = 0.002) scores were associated with the bleeding complications, and the cut-off values were 5.00 and 49.0, respectively. No definite stent thrombosis occurred in any of the patients. Short-term DAPT is feasible in AF patients treated with OAC after undergoing PCI with DES. The previous history of bleeding episodes and long-term aspirin use were associated with their 1-year serious bleeding events.

Keywords

Atrial fibrillation Drug-eluting stents Oral anticoagulation Antiplatelet therapy Percutaneous coronary intervention 

Notes

Acknowledgements

The authors are grateful to Manami Kumagai, Ai Saito, Shizuka Ito, and Saori Ichijo for their support in data collection and analysis of the catheterization findings.

Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

Compliance with ethical standards

Conflict of interest

The authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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Copyright information

© Japanese Association of Cardiovascular Intervention and Therapeutics 2019

Authors and Affiliations

  • Kazunori Horie
    • 1
    Email author
  • Takashi Matsumoto
    • 1
  • Yukiko Mizutani
    • 1
  • Norio Tada
    • 1
  • Norichika Osai
    • 1
  • Tsuyoshi Isawa
    • 1
  • Masataka Taguri
    • 2
  • Shigeaki Kato
    • 1
  • Taku Honda
    • 1
  • Tatsushi Ootomo
    • 1
  • Naoto Inoue
    • 1
  1. 1.Division of Cardiovascular Medicine, Department of Cardiovascular MedicineSendai Kousei HospitalSendaiJapan
  2. 2.Department of BiostaticsYokohama City University School of MedicineYokohamaJapan

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