Author + information
- Viet T. Le,
- Stacey Knight,
- Winslow Klaskala,
- Scott C. Woller,
- Benjamin Horne,
- Thomas Bunch,
- Roger Mills and
- J. Muhlestein
Acute coronary syndrome (ACS) patients benefit from dual antiplatelet therapy (DAPT), and most patients with atrial fibrillation (AF) merit anticoagulation stroke prophylaxis (AcP). Real world reporting of overall antithrombotic therapy among patients with ACS + AF is limited. We describe antithrombotic therapy in a large cohort of ACS patients discharged with AF.
911 patients with AF + ACS enrolled in the Intermountain Heart Collaborative Study registry from 2004–2009 were identified. Clinical variables and discharge antithrombotic therapy (single antiplatelet therapy [SAPT] ± AcP or DAPT ± AcP) were collected. Predictors of AcP at discharge were determined using multivariable logistic regression analyses (Table).
462 AF + ACS patients (50.7%) received coronary stents; 590 (64.8%) had a CHADS2 score ≥2. Only 15.6% received DAPT + AcP, 12.4% received SAPT + AcP, 48.9% DAPT only, 21.3% SAPT only, and 1.9% AcP only. Use of AcP did not differ based on CHADS2 score (≥2 = 31.2%; <2 = 27.4%; P=0.256).
Among patients with ACS + AF, fewer than one in three (30%) received AcP regardless of CHADS2 score; very few received DAPT + AcP. Scant data are available regarding optimal antithrombotic therapy management, and clinical trials are needed to guide therapy in this common and challenging patient population.
Poster Sessions, Expo North
Saturday, March 09, 2013, 10:00 a.m.-10:45 a.m.
Session Title: ACS Therapy: Antiplatelet Agents
Abstract Category: 3. Acute Coronary Syndromes: Therapy
Presentation Number: 1129-205
- 2013 American College of Cardiology Foundation