Effects of Triple Therapy in Patients With Non-Valvular Atrial Fibrillation Undergoing Percutaneous Coronary Intervention Regarding Thromboembolic Risk Stratification

Background: The effects of dual antiplatelet therapy (DAPT) and triple therapy (TT: DAPT plus oral anticoagulation) in patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI) regarding to CHA(2)DS(2)-VASc score remain undefined. We compare the effect of TT vs. DAPT...

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Autores: Sambola, A, Mutuberría, M, del Blanco, BG, Alonso, A, Barrabés, JA, Alfonso, F, Bueno, H, Cequier, A, Zueco, J, Rodríguez-Leor, O, Bosch, E, Tornos, P, García-Dorado, D
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2016
País:España
Institución:Institut d'Investigació i Innovació Parc Taulí (I3PT)
Repositorio:r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
OAI Identifier:oai:i3pt.fundanetsuite.com:p5876
Acceso en línea:https://i3pt.portalinvestigacion.com/publicaciones/5876
Access Level:acceso abierto
Palabra clave:Anticoagulation
Atrial fibrillation
Dual antiplatelet therapy
Percutaneous coronary intervention
Thromboembolic risk
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spelling Effects of Triple Therapy in Patients With Non-Valvular Atrial Fibrillation Undergoing Percutaneous Coronary Intervention Regarding Thromboembolic Risk StratificationSambola, AMutuberría, Mdel Blanco, BGAlonso, ABarrabés, JAAlfonso, FBueno, HCequier, AZueco, JRodríguez-Leor, OBosch, ETornos, PGarcía-Dorado, DAnticoagulationAtrial fibrillationDual antiplatelet therapyPercutaneous coronary interventionThromboembolic riskBackground: The effects of dual antiplatelet therapy (DAPT) and triple therapy (TT: DAPT plus oral anticoagulation) in patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI) regarding to CHA(2)DS(2)-VASc score remain undefined. We compare the effect of TT vs. DAPT in this setting regarding the CHA(2)DS(2)-VASc score. Methods and Results: In a prospective multicenter registry, 585 patients (75.2% male, 73.2+/-8.2 years) with AF undergoing PCI were followed up during 1 year. Of them, 157 (26.8%) had a CHA(2)DS(2)-VASc=1, and 428 (73.2%) had a CHA(2)DS(2)-VASc >= 2. TT was prescribed in 51.6% with CHA(2)DS(2)-VASc=1 and in 55.5% with CHA(2)DS(2)-VASc >= 2. Patients with CHA(2)DS(2)-VASc=1 receiving TT had a similar thromboembolism rate to those on DAPT (1.2% vs. 1.3%, P=0.73), but more total (19.5% vs. 6.9%, P=0.01) and a tendency to more major (4.9% vs. 0%, P=0.06) bleeding. However, patients with CHA(2)DS(2)-VASc >= 2 receiving TT had a lower thromboembolism rate (1.7% vs. 5.3%, P=0.03) and a trend towards more bleeds (21.8% vs. 15.6%, P=0.06), with an excess of major bleeding (8.4% vs. 3.1%, P=0.01). Rates of major adverse cardiac events (MACE) in both CHA(2)DS(2)-VASc subgroups were similar, irrespective of treatment. In a Cox multivariate analysis, TT was associated to major bleeding, but not with MACE. Conclusions: In patients with AF and CHA(2)DS(2)-VASc=1 undergoing PCI, the use of TT involves a high risk of bleeding without a significant benefit in preventing thromboembolism.JAPANESE CIRCULATION SOC2016info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://i3pt.portalinvestigacion.com/publicaciones/5876CIRCULATION JOURNALISSN: 13469843ISSNe: 13474820reponame:r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulíinstname:Institut d'Investigació i Innovació Parc Taulí (I3PT)Inglésinfo:eu-repo/semantics/openAccessoai:i3pt.fundanetsuite.com:p58762026-06-21T15:30:37Z
dc.title.none.fl_str_mv Effects of Triple Therapy in Patients With Non-Valvular Atrial Fibrillation Undergoing Percutaneous Coronary Intervention Regarding Thromboembolic Risk Stratification
title Effects of Triple Therapy in Patients With Non-Valvular Atrial Fibrillation Undergoing Percutaneous Coronary Intervention Regarding Thromboembolic Risk Stratification
spellingShingle Effects of Triple Therapy in Patients With Non-Valvular Atrial Fibrillation Undergoing Percutaneous Coronary Intervention Regarding Thromboembolic Risk Stratification
Sambola, A
Anticoagulation
Atrial fibrillation
Dual antiplatelet therapy
Percutaneous coronary intervention
Thromboembolic risk
title_short Effects of Triple Therapy in Patients With Non-Valvular Atrial Fibrillation Undergoing Percutaneous Coronary Intervention Regarding Thromboembolic Risk Stratification
title_full Effects of Triple Therapy in Patients With Non-Valvular Atrial Fibrillation Undergoing Percutaneous Coronary Intervention Regarding Thromboembolic Risk Stratification
title_fullStr Effects of Triple Therapy in Patients With Non-Valvular Atrial Fibrillation Undergoing Percutaneous Coronary Intervention Regarding Thromboembolic Risk Stratification
title_full_unstemmed Effects of Triple Therapy in Patients With Non-Valvular Atrial Fibrillation Undergoing Percutaneous Coronary Intervention Regarding Thromboembolic Risk Stratification
title_sort Effects of Triple Therapy in Patients With Non-Valvular Atrial Fibrillation Undergoing Percutaneous Coronary Intervention Regarding Thromboembolic Risk Stratification
dc.creator.none.fl_str_mv Sambola, A
Mutuberría, M
del Blanco, BG
Alonso, A
Barrabés, JA
Alfonso, F
Bueno, H
Cequier, A
Zueco, J
Rodríguez-Leor, O
Bosch, E
Tornos, P
García-Dorado, D
author Sambola, A
author_facet Sambola, A
Mutuberría, M
del Blanco, BG
Alonso, A
Barrabés, JA
Alfonso, F
Bueno, H
Cequier, A
Zueco, J
Rodríguez-Leor, O
Bosch, E
Tornos, P
García-Dorado, D
author_role author
author2 Mutuberría, M
del Blanco, BG
Alonso, A
Barrabés, JA
Alfonso, F
Bueno, H
Cequier, A
Zueco, J
Rodríguez-Leor, O
Bosch, E
Tornos, P
García-Dorado, D
author2_role author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Anticoagulation
Atrial fibrillation
Dual antiplatelet therapy
Percutaneous coronary intervention
Thromboembolic risk
topic Anticoagulation
Atrial fibrillation
Dual antiplatelet therapy
Percutaneous coronary intervention
Thromboembolic risk
description Background: The effects of dual antiplatelet therapy (DAPT) and triple therapy (TT: DAPT plus oral anticoagulation) in patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI) regarding to CHA(2)DS(2)-VASc score remain undefined. We compare the effect of TT vs. DAPT in this setting regarding the CHA(2)DS(2)-VASc score. Methods and Results: In a prospective multicenter registry, 585 patients (75.2% male, 73.2+/-8.2 years) with AF undergoing PCI were followed up during 1 year. Of them, 157 (26.8%) had a CHA(2)DS(2)-VASc=1, and 428 (73.2%) had a CHA(2)DS(2)-VASc >= 2. TT was prescribed in 51.6% with CHA(2)DS(2)-VASc=1 and in 55.5% with CHA(2)DS(2)-VASc >= 2. Patients with CHA(2)DS(2)-VASc=1 receiving TT had a similar thromboembolism rate to those on DAPT (1.2% vs. 1.3%, P=0.73), but more total (19.5% vs. 6.9%, P=0.01) and a tendency to more major (4.9% vs. 0%, P=0.06) bleeding. However, patients with CHA(2)DS(2)-VASc >= 2 receiving TT had a lower thromboembolism rate (1.7% vs. 5.3%, P=0.03) and a trend towards more bleeds (21.8% vs. 15.6%, P=0.06), with an excess of major bleeding (8.4% vs. 3.1%, P=0.01). Rates of major adverse cardiac events (MACE) in both CHA(2)DS(2)-VASc subgroups were similar, irrespective of treatment. In a Cox multivariate analysis, TT was associated to major bleeding, but not with MACE. Conclusions: In patients with AF and CHA(2)DS(2)-VASc=1 undergoing PCI, the use of TT involves a high risk of bleeding without a significant benefit in preventing thromboembolism.
publishDate 2016
dc.date.none.fl_str_mv 2016
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://i3pt.portalinvestigacion.com/publicaciones/5876
url https://i3pt.portalinvestigacion.com/publicaciones/5876
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv JAPANESE CIRCULATION SOC
publisher.none.fl_str_mv JAPANESE CIRCULATION SOC
dc.source.none.fl_str_mv CIRCULATION JOURNAL
ISSN: 13469843
ISSNe: 13474820
reponame:r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
instname:Institut d'Investigació i Innovació Parc Taulí (I3PT)
instname_str Institut d'Investigació i Innovació Parc Taulí (I3PT)
reponame_str r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
collection r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
repository.name.fl_str_mv
repository.mail.fl_str_mv
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