Key result
Acute coronary syndrome patients with atrial fibrillation were more likely to receive dual antiplatelet therapy (p<0.001), whereas stable coronary artery disease patients preferred anticoagulation.
Why the study?
Acute coronary syndrome and stable coronary artery disease occur frequently in patients with atrial fibrillation, but the optimal antithrombotic therapy remains debated.
What are the differences in antithrombotic therapy choices and readmission rates between acute coronary syndrome and stable coronary artery disease patients with atrial fibrillation?
Cohort (n=976)
What are the differences in antithrombotic therapy choices and readmission rates between acute coronary syndrome and stable coronary artery disease patients with atrial fibrillation?
In patients with coronary artery disease and atrial fibrillation, real-world practice shows ACS patients predominantly receive dual antiplatelet therapy while stable CAD patients receive anticoagulation, with stable patients experiencing higher readmission rates.
May inform individualized antithrombotic choices in AF with CAD; leaves open optimal regimens for randomized trials.
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.
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Wu et al. (2019) conducted a cohort in Coronary artery disease with atrial fibrillation (n=976). Acute coronary syndrome vs. Stable coronary artery disease was evaluated on Antithrombotic therapy choice and readmission. Acute coronary syndrome patients with atrial fibrillation were more likely to receive dual antiplatelet therapy (p<0.001), whereas stable coronary artery disease patients preferred anticoagulation.
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