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

Authors
 Oh-Hyun Lee  ;  Yongcheol Kim  ;  Deok-Kyu Cho  ;  Jung-Sun Kim  ;  Byeong-Keuk Kim  ;  Donghoon Choi  ;  Myeong-Ki Hong  ;  Myung Ho Jeong  ;  Yangsoo Jang 
Citation
 FRONTIERS IN CARDIOVASCULAR MEDICINE, Vol.8 : 762090, 2021-11 
Journal Title
FRONTIERS IN CARDIOVASCULAR MEDICINE
Issue Date
2021-11
Keywords
anticoagulants ; atrial fibrillation ; myocardial infarction ; percutaneous coronary intervention ; treatment outcome
Abstract
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.
Files in This Item:
T202105670.pdf Download
DOI
10.3389/fcvm.2021.762090
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Byeong Keuk(김병극) ORCID logo https://orcid.org/0000-0003-2493-066X
Kim, Yongcheol(김용철) ORCID logo https://orcid.org/0000-0001-5568-4161
Kim, Jung Sun(김중선) ORCID logo https://orcid.org/0000-0003-2263-3274
Lee, Oh Hyun(이오현) ORCID logo https://orcid.org/0000-0001-7070-7720
Cho, Deok Kyu(조덕규)
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
Hong, Myeong Ki(홍명기) ORCID logo https://orcid.org/0000-0002-2090-2031
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/187429
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