Value of DAPT score to predict adverse outcome in patients with atrial fibrillation undergoing percutaneous coronary intervention: A post-hoc analysis from the AFCAS registry

Background: The DAPT score identifies patients with expected benefit from extended dual antiplatelet therapy beyond 1 year after percutaneous coronary intervention (PCI). In a post-hoc analysis from the AFCAS registry, we explored the value of DAPT score to predict outcome in patients with atrial fi...

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Detalles Bibliográficos
Autores: Nammas, W, Kiviniemi, T, Schlitt, A, Rubboli, A, Valencia, J, Lip, GYH, Karjalainen, PP, Biancari, F, Airaksinen, KEJ
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2018
País:España
Institución:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
Repositorio:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
OAI Identifier:oai:isabial.fundanetsuite.com:p7951
Acceso en línea:https://isabial.portalinvestigacion.com/publicaciones7951
Access Level:acceso abierto
Palabra clave:Atrial fibrillation
Percutaneous coronary intervention
Oral anticoagulation
Descripción
Sumario:Background: The DAPT score identifies patients with expected benefit from extended dual antiplatelet therapy beyond 1 year after percutaneous coronary intervention (PCI). In a post-hoc analysis from the AFCAS registry, we explored the value of DAPT score to predict outcome in patients with atrial fibrillation (AF) undergoing PCI. Methods and results: Outcome measures included major adverse cardiac/cerebrovascular events (MACCE) [all-cause death, myocardial infarction, repeat revascularization, stent thrombosis, or stroke/transient ischemic attack] and bleeding events. At 12-month follow-up, patients with a DAPT score >= 1 had a higher incidence of MACCE, all-cause death, myocardial infarction (p = 0.004, p = 0.006, and p = 0.013, respectively), but a similar bleeding rate (p = 0.66), versus those with a DAPT score <1. In a subgroup of patients at high risk of stroke who received triple therapy for 1 month only, DAPT score >= 1 was associated with a higher incidence of MACCE, all-cause death, myocardial infarction (p = 0.002, p = 0.015, and p = 0.039, respectively), but a similar bleeding rate (p = 0.81). Conclusions: In AF patients undergoing PCI, a DAPT score >= 1 was associated with a higher incidence of thrombotic events, and a similar incidence of bleeding events, compared with a DAPT score <1. These results were consistent in patients at high risk of stroke who received triple therapy for 1 month. (c) 2017 Elsevier B.V. All rights reserved.