Comparison of mid-term outcomes between patients with and without atrial fibrillation undergoing coronary stenting in the second-generation drug-eluting stent era: from the SHINANO registry.

Autor: Miura, Takashi, Miyashita, Yusuke, Motoki, Hirohiko, Kobayashi, Hideki, Kobayashi, Masanori, Nakajima, Hiroyuki, Kimura, Hikaru, Akanuma, Hiroshi, Mawatari, Eiichiro, Sato, Toshio, Hotta, Shoji, Kamiyoshi, Yuichi, Maruyama, Takuya, Watanabe, Noboru, Eizawa, Takayuki, Aso, Shinichi, Uchikawa, Shinichiro, Hashizume, Naoto, Senda, Keisuke, Morita, Takehiro
Zdroj: Cardiovascular Intervention & Therapeutics; Jul2017, Vol. 32 Issue 3, p206-215, 10p
Abstrakt: Little is known about the mid-term outcomes of patients with atrial fibrillation (AF) who undergo coronary stenting in the second-generation drug-eluting stent (DES) era. We evaluated the 1-year outcomes of AF patients undergoing percutaneous coronary intervention (PCI) with second-generation DES. This retrospective cohort analysis used integrated data from the SHINANO registry, a prospective observational multicenter cohort study, which enrolled 1923 consecutive patients undergoing PCI for any coronary artery disease. We retrospectively recruited 917 of these patients (mean age, 71.3 ± 10.0 years; male, 77 %) who received PCI with 2nd generation DES. The primary endpoint was net adverse clinical events (NACE: cardiac death, stroke, MI, stent thrombosis, and major bleeding) at 1 year. The secondary endpoints were major adverse cardiovascular events (MACE: cardiac death, stroke, and MI), stroke, MI, and major bleeding at 1 year. One-year follow-up was completed in 871 (94.9 %) patients, of whom 85 had AF. The incidence of NACE (15.4 vs. 7.3 %, P = 0.008), MACE (10.6 vs. 5.4 %, P = 0.047), and major bleeding (6.0 vs. 2.3 %, P = 0.049) were all significantly higher in AF compared to non-AF patients. On multivariate analysis, AF was an independent predictor of NACE (HR 2.32, 95 % CI 1.24-4.34, P = 0.008). In the second-generation DES era, patients with AF undergoing PCI still have a poorer prognosis, with more thrombotic and bleeding events, than those without AF. More attention should be paid to the thrombotic and bleeding risk in AF patients undergoing PCI. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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