Outcomes of anticoagulated patients with atrial fibrillation treated with or without antiplatelet therapy - A pooled analysis from the PREFER in AF and PREFER in AF PROLONGATON registries

International Journal of Cardiology
Giuseppe PattiRaffaele De Caterina

Abstract

Evidence on whether antiPLT added to OACs is of advantage in atrial fibrillation (AF) patients with concomitant stable coronary artery disease (CAD) is limited. We evaluated clinical outcomes with oral anticoagulant (OAC) monotherapy vs antiplatelet therapy (antiPLT) plus OAC in patients with AF and stable CAD. Data on 1058 AF patients on OACs and history (>1 year) of myocardial infarction or coronary stenting were pooled from the PREFER-in-AF and PREFER-in-AF PROLONGATION registries. We primarily compared the 1-year incidence of a net composite endpoint (primary endpoint), including acute coronary syndrome and major bleeding, with or without antiPLT. The incidence of the primary net composite endpoint was significantly higher in patients receiving OACs + antiPLT (N = 348) vs OACs alone (N = 710): 7.9 vs 4.2 per 100 patients/year; adjusted OR [95% CI] 1.84 [1.01-3.37]; p = 0.048. Among the components of the primary endpoint, the greatest relative difference was found for major bleeding (OR [95% CI] 2.28 [95% CI 1.00-5.19]), and especially life-threatening or non-gastrointestinal bleeding. The net clinical outcome with OACs + antiPLT was poorer irrespective of the type of CAD (previous infarction or coronary stenting), the type ...Continue Reading

Citations

Dec 19, 2019·The New England Journal of Medicine·Guillaume Marquis-Gravel, Matthew T Roe
Dec 19, 2019·Frontiers in Cardiovascular Medicine·Małgorzata OstrowskaJolanta M Siller-Matula
Mar 25, 2019·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Giuseppe BorianiUNKNOWN EORP-AF Long-Term General Registry Investigators
Apr 3, 2020·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Andreas GoetteGregory Y H Lip
Dec 19, 2019·The New England Journal of Medicine·Satoshi YasudaUNKNOWN AFIRE Investigators
Dec 19, 2019·The New England Journal of Medicine·Thomas Gremmel
May 7, 2021·Clinical Interventions in Aging·Rungroj KrittayaphongUNKNOWN COOL-AF Investigators

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