Why the study?
The optimal antithrombotic therapy in patients with atrial fibrillation and myocardial infarction has not been definitively resolved.
What clinical factors and antithrombotic treatments are associated with long-term prognosis in patients with atrial fibrillation and myocardial infarction?
What clinical factors and antithrombotic treatments are associated with long-term prognosis in patients with atrial fibrillation and myocardial infarction?
In an observational cohort of patients with AF and MI, aspirin use was associated with improved survival and combined outcomes, whereas double or triple antithrombotic therapy showed no significant association with these outcomes.
Background and Objectives: The problem of treating patients with atrial fibrillation and myocardial infarction is relevant. The issue of optimal antithrombotic therapy in these patients has not been definitively resolved. This work analyzes the influence of clinical factors and treatment on the long-term prognosis of patients. Materials and Methods: The research included 360 patients with atrial fibrillation and myocardial infarction during 2016–2019. Results: The factors associated with fatal outcomes were age (hazard ratio (HR): 1.05; 95% confidence interval (CI): 1.03–1.07; p < 0.001); stroke (HR: 1.95; 95% CI: 1.27–3.00; p = 0.0002); glomerular filtration rate (HR: 0.988; 95% CI: 0.978–0.998; p = 0.03); left ventricular ejection fraction (HR: 0.975; 95% CI: 0.957–0.999; p = 0.007); and aspirin (HR: 0.48; 95% CI: 0.31–0.73; p < 0.001). The factors associated with the combined endpoint were chronic kidney disease (HR: 1.46; 95% CI: 1.01–2.10; p = 0.04); HAS-BLED (HR: 1.23; 95% CI: 1.06–1.43; p = 0.007); percutaneous coronary intervention (HR: 0.70; 95% CI: 0.51–0.96; p = 0.03); and aspirin (HR: 0.65; 95% CI: 0.44–0.97; p = 0.03). Conclusions: Double and triple antithrombotic therapy were not associated with outcomes. Aspirin improved the prognosis for survival and the combined endpoint.
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Yаkushin et al. (2023) studied this question.
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