Antithrombotic therapy and its impact on prognosis in patients with atrial fibrillation and myocardial infarction. Long-term observation results

Aim. To study antithrombotic therapy (ATT) in patients with myocardial infarction (MI) type 1 and preexisting atrial fibrillation (AF), effect of ATT on prognosis. Material and methods. 100 patients with type 1 MI and preexisting AF were selected. The exclusion criterion was severe concomitant pa...

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Autores principales:	Mariia V. Soloveva, Svetlana A. Boldueva
Formato:	article
Lenguaje:	EN RU
Publicado:	Concilium Medicum 2021
Materias:	atrial fibrillation myocardial infarction antithrombotic therapy anticoagulants prognosis adherence to anticoagulants Diseases of the circulatory (Cardiovascular) system RC666-701 Diseases of the endocrine glands. Clinical endocrinology RC648-665
Acceso en línea:	https://doaj.org/article/ab1e18068ca8440f981e0356eff8f006
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spelling	oai:doaj.org-article:ab1e18068ca8440f981e0356eff8f0062021-12-01T22:07:02ZAntithrombotic therapy and its impact on prognosis in patients with atrial fibrillation and myocardial infarction. Long-term observation results2221-71852658-570710.17816/22217185.2021.3.201044https://doaj.org/article/ab1e18068ca8440f981e0356eff8f0062021-10-01T00:00:00Zhttps://cardiosomatics.orscience.ru/2221-7185/article/viewFile/83285/63774https://doaj.org/toc/2221-7185https://doaj.org/toc/2658-5707Aim. To study antithrombotic therapy (ATT) in patients with myocardial infarction (MI) type 1 and preexisting atrial fibrillation (AF), effect of ATT on prognosis. Material and methods. 100 patients with type 1 MI and preexisting AF were selected. The exclusion criterion was severe concomitant pathology. Results. Only 13.0% of AF patients took anticoagulants (AC) adequately before hospitalization. 94.0% of patients in hospital and 80.5% at discharge were prescribed triple ATT at least for 1 month with transition to dual ATT (AC + disaggregant) for 12 months. ACs were prescribed in hospital in 100.0% of cases, at discharge in 93.1%. After 1 year 8.4% of patients stopped taking ACs, after 2.31.9 years 15.7%. The incidence of ischemic and hemorrhagic events didnt differ in patients with different regimens of ATT (double/triple) and types of AСs (vitamin K antagonists/non-vitamin K antagonist ACs). In the long-term period patients, who took ACs incorrectly or stopped taking ACs, had increased risks of stroke (OR 9.580; 95% CI 1.15379.599, p=0.0365); combined endpoint: recurrent MI + stroke + cardiovascular mortality (OR 2.556; 95% CI 1.1045.918, p=0.0284). Сonclusion. Patients with preexisting AF had a low adherence to ACs prior to MI. It increased after hospitalization and decreased during follow-up. In the long-term period patients, who took ACs incorrectly or stopped taking ACs, had significantly increased risks of stroke, combined endpoint. There were no differences in the prognosis depending on the type of ACs, the regimens of ATT administered in accordance with ischemic and hemorrhagic risks.Mariia V. SolovevaSvetlana A. BolduevaConcilium Medicumarticleatrial fibrillationmyocardial infarctionantithrombotic therapyanticoagulantsprognosisadherence to anticoagulantsDiseases of the circulatory (Cardiovascular) systemRC666-701Diseases of the endocrine glands. Clinical endocrinologyRC648-665ENRUКардиоСоматика, Vol 12, Iss 3, Pp 158-165 (2021)
institution	DOAJ
collection	DOAJ
language	EN RU
topic	atrial fibrillation myocardial infarction antithrombotic therapy anticoagulants prognosis adherence to anticoagulants Diseases of the circulatory (Cardiovascular) system RC666-701 Diseases of the endocrine glands. Clinical endocrinology RC648-665
spellingShingle	atrial fibrillation myocardial infarction antithrombotic therapy anticoagulants prognosis adherence to anticoagulants Diseases of the circulatory (Cardiovascular) system RC666-701 Diseases of the endocrine glands. Clinical endocrinology RC648-665 Mariia V. Soloveva Svetlana A. Boldueva Antithrombotic therapy and its impact on prognosis in patients with atrial fibrillation and myocardial infarction. Long-term observation results
description	Aim. To study antithrombotic therapy (ATT) in patients with myocardial infarction (MI) type 1 and preexisting atrial fibrillation (AF), effect of ATT on prognosis. Material and methods. 100 patients with type 1 MI and preexisting AF were selected. The exclusion criterion was severe concomitant pathology. Results. Only 13.0% of AF patients took anticoagulants (AC) adequately before hospitalization. 94.0% of patients in hospital and 80.5% at discharge were prescribed triple ATT at least for 1 month with transition to dual ATT (AC + disaggregant) for 12 months. ACs were prescribed in hospital in 100.0% of cases, at discharge in 93.1%. After 1 year 8.4% of patients stopped taking ACs, after 2.31.9 years 15.7%. The incidence of ischemic and hemorrhagic events didnt differ in patients with different regimens of ATT (double/triple) and types of AСs (vitamin K antagonists/non-vitamin K antagonist ACs). In the long-term period patients, who took ACs incorrectly or stopped taking ACs, had increased risks of stroke (OR 9.580; 95% CI 1.15379.599, p=0.0365); combined endpoint: recurrent MI + stroke + cardiovascular mortality (OR 2.556; 95% CI 1.1045.918, p=0.0284). Сonclusion. Patients with preexisting AF had a low adherence to ACs prior to MI. It increased after hospitalization and decreased during follow-up. In the long-term period patients, who took ACs incorrectly or stopped taking ACs, had significantly increased risks of stroke, combined endpoint. There were no differences in the prognosis depending on the type of ACs, the regimens of ATT administered in accordance with ischemic and hemorrhagic risks.
format	article
author	Mariia V. Soloveva Svetlana A. Boldueva
author_facet	Mariia V. Soloveva Svetlana A. Boldueva
author_sort	Mariia V. Soloveva
title	Antithrombotic therapy and its impact on prognosis in patients with atrial fibrillation and myocardial infarction. Long-term observation results
title_short	Antithrombotic therapy and its impact on prognosis in patients with atrial fibrillation and myocardial infarction. Long-term observation results
title_full	Antithrombotic therapy and its impact on prognosis in patients with atrial fibrillation and myocardial infarction. Long-term observation results
title_fullStr	Antithrombotic therapy and its impact on prognosis in patients with atrial fibrillation and myocardial infarction. Long-term observation results
title_full_unstemmed	Antithrombotic therapy and its impact on prognosis in patients with atrial fibrillation and myocardial infarction. Long-term observation results
title_sort	antithrombotic therapy and its impact on prognosis in patients with atrial fibrillation and myocardial infarction. long-term observation results
publisher	Concilium Medicum
publishDate	2021
url	https://doaj.org/article/ab1e18068ca8440f981e0356eff8f006
work_keys_str_mv	AT mariiavsoloveva antithrombotictherapyanditsimpactonprognosisinpatientswithatrialfibrillationandmyocardialinfarctionlongtermobservationresults AT svetlanaaboldueva antithrombotictherapyanditsimpactonprognosisinpatientswithatrialfibrillationandmyocardialinfarctionlongtermobservationresults
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Antithrombotic therapy and its impact on prognosis in patients with atrial fibrillation and myocardial infarction. Long-term observation results

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