Management of Antithrombotic Therapy in Patients With Coexisting Atrial
Fibrillation and Coronary Artery Disease Who Underwent Percutaneous Coronary
Intervention Within the Last Year
#MMPMID41099276
König S
; Hohenstein S
; Leiner J
; Nitsche A
; Staudt A
; Steinborn F
; Bietau C
; Baberg HT
; Niehaus M
; Tebbenjohanns J
; Seyfarth M
; Ferrari MW
; Vorpahl MM
; Kuhlen R
; Bode K
; Bollmann A
Clin Cardiol
2025[Oct]; 48
(10
): e70196
PMID41099276
show ga
BACKGROUND: Coronary artery disease (CAD) is a common comorbidity in patients
with atrial fibrillation (AF), and optimal antithrombotic medication improves
clinical outcomes in this high-risk population. The aim of our study was to
describe antithrombotic drug regimens in different patient cohorts. METHODS: We
investigated data from the prospective Helios Heart registry (H2) and the Heart
Center Leipzig routine clinical database (HZL). We included inpatient cases with
AF and CAD (hospitalized from March 2021 to July 2024 [H2] or January 2017 to
December 2021 [HZL]), who underwent percutaneous coronary intervention (PCI)
within the last 12 months. Information on clinical characteristics, coronary
interventions, and medication prescribed was obtained from electronic case report
forms and/or administrative data based on ICD-10, OPS, and ATC codes. RESULTS: We
included 3481 (HZL), and 205 (H2) index cases with comparable baseline
characteristics. Overall, 92.5% (HZL) and 87.6% (H2) of patients were on any
anticoagulation, and 93.0% (HZL) and 80.2% (H2) were prescribed ??1 antiplatelet
agent. There were relevant differences in antithrombotic therapy when stratifying
for PCI timing. Factors associated with higher (older age) or lower (comorbidity
burden, antiplatelet treatment, prior left atrial appendage occlusion)
prescription rates of OAC were identified. OAC therapy without adjunctive
antiplatelet therapy was associated with an increased rate of rehospitalization
for major adverse cardiovascular events at 12 months (HZL). CONCLUSION: We
presented current data on antithrombotic drug utilization in patients with AF and
CAD and found comorbidity burden, concomitant antiplatelet treatment and other
factors to be associated with lower anticoagulant prescription rates.
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