Antithrombotic therapy in acute coronary syndrome and stable coronary artery disease patients with atrial fibrillation: a 3-year retrospective cohort study

Per Med. 2019 Sep;16(5):399-407. doi: 10.2217/pme-2018-0092. Epub 2019 Oct 8.

Abstract

Aim: Acute coronary syndrome (ACS) and stable coronary artery disease (SCAD) occur frequently in patients with atrial fibrillation (AF). However, the optimal antithrombotic therapy is still debated. Methods & results: We analyzed 976 coronary artery disease patients with AF from 2013 to 2014. ACS+AF patients tend to take dual antiplatelet therapy (p < 0.001), whereas SCAD+AF patients prefer anticoagulation therapy (warfarin: p < 0.001, dabigatran: p < 0.05). Ventricular arrhythmia, congestive heart failure and ACS were the top three reasons for SCAD group patients' readmission, while reinfarction and congestive heart failure were two major factors in readmission of ACS group. Conclusion: ACS+AF group patients more likely choose dual antiplatelet therapy, whereas SCAD+AF group patients prefer anticoagulation therapy. Compared with ACS group, SCAD group had a higher rate of readmission.

Keywords: acute coronary syndrome; anticoagulation; antiplatelet; antithrombotic therapy; atrial fibrillation; coronary artery disease; dual antiplatelet therapy; dual therapy; major adverse events; readmission; triple therapy.