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Background: No predictive clinical risk scores for net adverse clinical events (NACE) have been developed in patients with atrial fibrillation (AF) after percutaneous coronary intervention (PCI). Methods: We evaluated the NACE in order to develop clinically applicable risk-stratification scores in the BIWACO study, a multicenter survey which enrolled a total of 7837 patients. We also investigated the current status and time trends for the use of antithrombotic drugs.Results: A total of 188 AF patients who had received PCI were enrolled. At discharge, 65% of patients were prescribed a triple therapy (TT), 6% were prescribed a dual therapy, the remaining 29% of patients received dual-antiplatelet therapy. Over 3 years, the fraction of patients continuing TT decreased by 15%, whereas only 2% received oral anticoagulant alone. NACE developed in 20% of patients, resulting in the deaths of 5% patients, and 13% experiencing bleeding events. We developed risk scores for NACE comprising the five best predictive items, which we designated BIWACO scores. The area under the curve was 0.774 for NACE. Conclusions: Our study explored the differences in treatment practices and guideline recommendations for antithrombotic therapy. We concluded that our BIWACO score is useful for predicting clinical outcomes in AF-patients after PCI. |
