Temporal Trends of Antithrombotic Therapy in Patients With Acute Myocardial Infarction and Atrial Fibrillation: Insight From the KAMIR-NIH Registry

Background: Triple therapy is the combination of dual antiplatelet therapy plus oral anticoagulant after stent implantation. Current guidelines recommend triple therapy for acute coronary syndrome with atrial fibrillation (AF). This study aimed to identify temporal trends of antithrombotic therapy i...

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Autores principales:	Oh-Hyun Lee, Yongcheol Kim, Deok-Kyu Cho, Jung-Sun Kim, Byeong-Keuk Kim, Donghoon Choi, Myeong-Ki Hong, Myung Ho Jeong, Yangsoo Jang, the KAMIR-NIH Investigators
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	atrial fibrillation myocardial infarction percutaneous coronary intervention anticoagulants treatment outcome Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/b3cb278cbdce4b088806c0e1425c92bf
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spelling	oai:doaj.org-article:b3cb278cbdce4b088806c0e1425c92bf2021-12-01T00:31:22ZTemporal Trends of Antithrombotic Therapy in Patients With Acute Myocardial Infarction and Atrial Fibrillation: Insight From the KAMIR-NIH Registry2297-055X10.3389/fcvm.2021.762090https://doaj.org/article/b3cb278cbdce4b088806c0e1425c92bf2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fcvm.2021.762090/fullhttps://doaj.org/toc/2297-055XBackground: Triple therapy is the combination of dual antiplatelet therapy plus oral anticoagulant after stent implantation. Current guidelines recommend triple therapy for acute coronary syndrome with atrial fibrillation (AF). This study aimed to identify temporal trends of antithrombotic therapy in patients with acute myocardial infarction (AMI) and AF.Methods: Among 13,104 consecutive patients from the Korea Acute Myocardial Infarction Registry-National Institute of Health (KAMIR-NIH) registry, we identified 453 patients with AF after stent implantation for AMI; these patients were then divided into those who did and did not use oral anticoagulant (OAC) [OAC group (n = 71) vs. non-OAC group (n = 382), respectively].Results: The results showed that the prevalence of AF in AMI patients was 5.4% (712/13,104). Among 453 patients, only 15.7% (71/453) were treated with OAC while dual or single antiplatelet therapy was provided for 84.7% (382/453) of patients. In patients with high stroke risk (CHA2DS2-VASc score ≥ 2), OACs were used only in 17% (69/406). Multivariate analysis revealed that female sex [odds ratio (OR) 2.11; 95% CI: 1.17–3.79], diabetes mellitus (DM) (OR 2.37; 95% CI: 1.35–4.17), prior cerebrovascular accident (CVA) (OR 4.19; 95% CI: 2–8.75), and congestive heart failure (CHF) (OR 1.89; 95% CI: 1.09–3.3) as the significant determinants of OAC use.Conclusion: The study concluded that OAC was underused. Approximately, 15%, of AMI patients with AF undergoing PCI with stent and female gender, DM, prior CVA history, and a history of CHF or the presence of moderate to severe left ventricle systolic impairment were significant determinants of OAC use.Oh-Hyun LeeYongcheol KimDeok-Kyu ChoJung-Sun KimByeong-Keuk KimDonghoon ChoiMyeong-Ki HongMyung Ho JeongYangsoo Jangthe KAMIR-NIH InvestigatorsFrontiers Media S.A.articleatrial fibrillationmyocardial infarctionpercutaneous coronary interventionanticoagulantstreatment outcomeDiseases of the circulatory (Cardiovascular) systemRC666-701ENFrontiers in Cardiovascular Medicine, Vol 8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	atrial fibrillation myocardial infarction percutaneous coronary intervention anticoagulants treatment outcome Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	atrial fibrillation myocardial infarction percutaneous coronary intervention anticoagulants treatment outcome Diseases of the circulatory (Cardiovascular) system RC666-701 Oh-Hyun Lee Yongcheol Kim Deok-Kyu Cho Jung-Sun Kim Byeong-Keuk Kim Donghoon Choi Myeong-Ki Hong Myung Ho Jeong Yangsoo Jang the KAMIR-NIH Investigators Temporal Trends of Antithrombotic Therapy in Patients With Acute Myocardial Infarction and Atrial Fibrillation: Insight From the KAMIR-NIH Registry
description	Background: Triple therapy is the combination of dual antiplatelet therapy plus oral anticoagulant after stent implantation. Current guidelines recommend triple therapy for acute coronary syndrome with atrial fibrillation (AF). This study aimed to identify temporal trends of antithrombotic therapy in patients with acute myocardial infarction (AMI) and AF.Methods: Among 13,104 consecutive patients from the Korea Acute Myocardial Infarction Registry-National Institute of Health (KAMIR-NIH) registry, we identified 453 patients with AF after stent implantation for AMI; these patients were then divided into those who did and did not use oral anticoagulant (OAC) [OAC group (n = 71) vs. non-OAC group (n = 382), respectively].Results: The results showed that the prevalence of AF in AMI patients was 5.4% (712/13,104). Among 453 patients, only 15.7% (71/453) were treated with OAC while dual or single antiplatelet therapy was provided for 84.7% (382/453) of patients. In patients with high stroke risk (CHA2DS2-VASc score ≥ 2), OACs were used only in 17% (69/406). Multivariate analysis revealed that female sex [odds ratio (OR) 2.11; 95% CI: 1.17–3.79], diabetes mellitus (DM) (OR 2.37; 95% CI: 1.35–4.17), prior cerebrovascular accident (CVA) (OR 4.19; 95% CI: 2–8.75), and congestive heart failure (CHF) (OR 1.89; 95% CI: 1.09–3.3) as the significant determinants of OAC use.Conclusion: The study concluded that OAC was underused. Approximately, 15%, of AMI patients with AF undergoing PCI with stent and female gender, DM, prior CVA history, and a history of CHF or the presence of moderate to severe left ventricle systolic impairment were significant determinants of OAC use.
format	article
author	Oh-Hyun Lee Yongcheol Kim Deok-Kyu Cho Jung-Sun Kim Byeong-Keuk Kim Donghoon Choi Myeong-Ki Hong Myung Ho Jeong Yangsoo Jang the KAMIR-NIH Investigators
author_facet	Oh-Hyun Lee Yongcheol Kim Deok-Kyu Cho Jung-Sun Kim Byeong-Keuk Kim Donghoon Choi Myeong-Ki Hong Myung Ho Jeong Yangsoo Jang the KAMIR-NIH Investigators
author_sort	Oh-Hyun Lee
title	Temporal Trends of Antithrombotic Therapy in Patients With Acute Myocardial Infarction and Atrial Fibrillation: Insight From the KAMIR-NIH Registry
title_short	Temporal Trends of Antithrombotic Therapy in Patients With Acute Myocardial Infarction and Atrial Fibrillation: Insight From the KAMIR-NIH Registry
title_full	Temporal Trends of Antithrombotic Therapy in Patients With Acute Myocardial Infarction and Atrial Fibrillation: Insight From the KAMIR-NIH Registry
title_fullStr	Temporal Trends of Antithrombotic Therapy in Patients With Acute Myocardial Infarction and Atrial Fibrillation: Insight From the KAMIR-NIH Registry
title_full_unstemmed	Temporal Trends of Antithrombotic Therapy in Patients With Acute Myocardial Infarction and Atrial Fibrillation: Insight From the KAMIR-NIH Registry
title_sort	temporal trends of antithrombotic therapy in patients with acute myocardial infarction and atrial fibrillation: insight from the kamir-nih registry
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/b3cb278cbdce4b088806c0e1425c92bf
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Temporal Trends of Antithrombotic Therapy in Patients With Acute Myocardial Infarction and Atrial Fibrillation: Insight From the KAMIR-NIH Registry

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