Author + information
- Stacey Knight,
- Winslow Klaskala,
- Scott Woller,
- Benjamin Horne,
- Thomas Bunch,
- Viet Le,
- Roger Mills and
- J. Muhlestein
It is unclear what factors determine the use of anticoagulants among patients presenting with acute coronary syndrome (ACS), in which the use of single (SAPT) or dual (DAPT) antiplatelet therapy is required.
We retrospectively evaluated clinical factors associated with in-hospital and post-discharge anticoagulant use among 5378 ACS patients enrolled in the Intermountain Heart Collaborative Study from 2004–2009. Multivariable logistic regression analyses were used to determine predictors of anticoagulant use in patients receiving SAPT or DAPT.
In hospital, 99% of patients received an anticoagulant (83% heparin, 16% low molecular weight heparin, 12% warfarin, 8% other), 80% received DAPT, and 18% SAPT. Post-discharge, only 9% received anticoagulation (warfarin); 77% received DAPT and 20% SAPT (Table). Warfarin was prescribed in 7% of DAPT and 17% of SAPT patients; <1% received warfarin alone. Warfarin was used more frequently in patients with myocardial infarction (MI) (ST-elevation MI [STEMI] 11%, non-STEMI 10%, unstable angina 7%).
Among >5000 ACS patients, in-hospital use of anticoagulants was nearly universal. Post-discharge, warfarin use was rare and usually associated with the traditional indications of venous thromboembolism or atrial fibrillation. It was more frequently used with SAPT and prescribed slightly more frequently to STEMI and non-STEMI patients. How anticoagulation decisions affect long-term outcome requires further study.
Poster Sessions, Expo North
Saturday, March 09, 2013, 3:45 p.m.-4:30 p.m.
Session Title: ACS Therapy: Key Observational Data
Abstract Category: 3. Acute Coronary Syndromes: Therapy
Presentation Number: 1168-179
- 2013 American College of Cardiology Foundation