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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

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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.

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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.

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

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Authors and Affiliations

  1. Division of Cardiovascular Medicine, Department of Cardiovascular Medicine, Sendai Kousei Hospital, 4-15 Hirose-cho, Aoba-ku, Sendai, Miyagi, 980-0873, Japan

    Kazunori Horie, Takashi Matsumoto, Yukiko Mizutani, Norio Tada, Norichika Osai, Tsuyoshi Isawa, Shigeaki Kato, Taku Honda, Tatsushi Ootomo & Naoto Inoue

  2. Department of Biostatics, Yokohama City University School of Medicine, Yokohama, Kanagawa, Japan

    Masataka Taguri

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  1. Kazunori Horie
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  2. Takashi Matsumoto
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Correspondence to Kazunori Horie.

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Horie, K., Matsumoto, T., Mizutani, Y. et al. 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. Cardiovasc Interv and Ther 35, 150–161 (2020). https://doi.org/10.1007/s12928-019-00589-7

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