[Efficacy and safety of new oral anticoagulants as part of triple antithrombotic therapy in patients with atrial fibrillation and acute coronary syndrome. Data from an observational study]
| Autor: | N. N. Paikova, N A Sycheva, A M Kisel, A T Volkova, V. P. Nosov, G. V. Kovaleva, L. Yu. Koroleva |
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| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Acute coronary syndrome Administration Oral 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Fibrinolytic Agents Internal medicine Antithrombotic Atrial Fibrillation medicine Humans 030212 general & internal medicine Myocardial infarction Prospective Studies Acute Coronary Syndrome Prospective cohort study business.industry Warfarin Anticoagulants Atrial fibrillation medicine.disease Stroke Cohort Cardiology and Cardiovascular Medicine business TIMI medicine.drug |
| Zdroj: | Kardiologiia. 60(7) |
| ISSN: | 0022-9040 |
| Popis: | Aim To study efficacy and safety of a triple antithrombotic therapy with direct oral anticoagulants (DOAC) versus warfarin in patients with atrial fibrillation after acute coronary syndrome, for 12 months following discharge from the hospital.Materials and methods This single-site cohort, prospective, observational study performed at the Regional Vascular Center 2 of the N.A. Semashko Nizhniy Novgorod Regional Clinical Hospital included 402 patients. It was possible to maintain contacts with 206 patients for 12 months. These patients were divided into two groups, the DOAC treatment (n=105) and the warfarin treatment (n=101) as a part of triple antithrombotic therapy upon discharge. Clinical observation was performed at 1, 3, 6, and 12 months after the discharge by structured telephone interview. Predetermined efficacy endpoints included cardiovascular death, myocardial infarction, stent thrombosis, and ischemic stroke. Safety endpoints included bleeding defined as small, medium (clinically significant), and major in accordance with the TIMI classification.Results At 12 months of follow-up, 80 patients (76.19%) continued taking DOAC and 39 patients (38.61%, p70%, death rate did not differ in the warfarin and the DOAC treatment groups. However, there was a difference in reaching the composite efficacy endpoint (p=0.048): ischemic events occurred statistically significantly more frequently in the warfarin treatment group than in the DOAC treatment group.Conclusions In 12 months after discharge from the hospital, compliance with the DOAC treatment as a part of the antithrombotic therapy was significantly higher than compliance with the warfarin treatment. The triple antithrombotic therapy with DOAC was safer than the warfarin treatment by the number of hemorrhagic complications and more effective in prevention of ischemic events, primarily due to no need for monitoring of lab test values. |
| Databáze: | OpenAIRE |
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