Value of DAPT score to predict adverse outcome in patients with atrial fibrillation undergoing percutaneous coronary intervention: A post-hoc analysis from the AFCAS registry

INTERNATIONAL JOURNAL OF CARDIOLOGY

卷:253

Article

Nammas, Wail¹  Kiviniemi, Tuomas²  Schlitt, Axel^3,4  Rubboli, Andrea⁵  Valencia, Jose⁶  Lip, Gregory Y. H.^7,8  Karjalainen, Pasi P.¹  Biancari, Fausto⁹  Airaksinen, K. E. Juhani² 

[1] Satakunta Cent Hosp, Ctr Heart, Pori, Finland

[2] Univ Turku, Turku Univ Hosp, Ctr Heart, Turku, Finland

[3] Martin Luther Univ Halle Wittenberg, Fac Med, Halle, Germany

[4] Paracelsus Harz Clin Bad Suderode, Dept Cardiol, Quedlinburg, Germany

[5] Osped Maggiore Bologna, Div Cardiol, Lab Intervent Cardiol, Bologna, Italy

[6] Gen Hosp Univ Alicante, Dept Cardiol, Alicante, Spain

[7] Univ Birmingham, Inst Cardiovasc Sci, City Hosp, Birmingham, W Midlands, England

[8] Aalborg Univ, Dept Clin Med, Aalborg Thrombosis Res Unit, Aalborg, Denmark

[9] Oulu Univ Hosp, Dept Surg, Oulu, Finland

关键词: Atrial fibrillation;    Percutaneous coronary intervention;    Oral anticoagulation;   

DOI  :  10.1016/j.ijcard.2017.07.074

来源: Elsevier

【 摘 要 】

Background: The DAPT score identifies patients with expected benefit from extended dual antiplatelet therapy beyond 1 year after percutaneous coronary intervention (PCI). In a post-hoc analysis from the AFCAS registry, we explored the value of DAPT score to predict outcome in patients with atrial fibrillation (AF) undergoing PCI. Methods and results: Outcome measures included major adverse cardiac/cerebrovascular events (MACCE) [all-cause death, myocardial infarction, repeat revascularization, stent thrombosis, or stroke/transient ischemic attack] and bleeding events. At 12-month follow-up, patients with a DAPT score >= 1 had a higher incidence of MACCE, all-cause death, myocardial infarction (p = 0.004, p = 0.006, and p = 0.013, respectively), but a similar bleeding rate (p = 0.66), versus those with a DAPT score <1. In a subgroup of patients at high risk of stroke who received triple therapy for 1 month only, DAPT score >= 1 was associated with a higher incidence of MACCE, all-cause death, myocardial infarction (p = 0.002, p = 0.015, and p = 0.039, respectively), but a similar bleeding rate (p = 0.81). Conclusions: In AF patients undergoing PCI, a DAPT score >= 1 was associated with a higher incidence of thrombotic events, and a similar incidence of bleeding events, compared with a DAPT score <1. These results were consistent in patients at high risk of stroke who received triple therapy for 1 month. (c) 2017 Elsevier B.V. All rights reserved.

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