ABSTRACT
Objective:
To investigate the current status of antithrombotic strategy for
elderly patients with
atrial fibrillation (AF) and
acute coronary syndrome (ACS) after
stent implantation in
Beijing area and to study the
safety and
efficacy of different
therapeutic strategy.
Methods:
A total of 467 relevant
patients were enrolled by re-travelling
electronic medical records from 12
hospitals in
Beijing area. The
patients' mean age was (78.70±3.32) years and they were divided into 2 groups by antithrombotic
therapy condition Triple
therapy group, n=17 (3.64%), Double
therapy group, n=450 (96.36%). The
incidence of major adverse cardiac and cerebral events (MACCE) including all-caused
death, non-fatal
myocardial infarction,
stent thrombosis, target vessel revascularization (TVR), stoke and
bleeding was compared between Triple
therapy group and Double
therapy group.
Results:
The medication in Double
therapy group included
aspirin+
ticagrelor,
aspirin+
clopidogrel,
clopidogrel+
warfarin and
cilostazol+
clopidogrel; in Triple
therapy group was
aspirin+
clopidogrel+
warfarin.
Patient with HAS-BLED score≥3 was defined as high
risk of
bleeding and they were all treated by double
therapy; HAS-BLED<3 was defined as low
risk of
bleeding, only 5.03%
patients were treated by triple
therapy. 3
patients in Triple
therapy group and 33 in Double
therapy group suffered from gastrointestinal
bleeding, P=0.338; 6
patients in Triple
therapy group and 128 in Double
therapy group had MACCE, P=0.589; 3 and 80
patients died in Triple
therapy group and Double
therapy group, P=0.766.
Conclusion:
Triple
therapy was rarely used in
elderly AF and ACS
patients after
stent implantation, double
therapy was the main strategy; the
incidence of MACCE and
mortality were
similar between triple and double
therapies;
patients with triple
therapy had the higher
incidence of gastrointestinal
bleeding.