Author + information
- Kenneth Kitaa,b,
- Akash Rusiaa,b,
- Shawn Shaha,b,
- Youning Zhanga,b,
- Dipayon Roya,b,
- Jonathan Nattiva,b,
- Natasha Doshia,b,
- Han Tuna,b,
- Leonardo Clavijoa,b and
- Rahul N. Doshia,b
Background: Patients with atrial fibrillation (AF) and high risk of thromboembolism (TE) who get percutaneous coronary intervention (PCI) need oral anticoagulation (AC) and dual antiplatelet therapy–triple therapy. This study evaluates if cerebrovascular accident (CVA) or risk of TE by CHADS2-VASc influences AC decisions post PCI.
Methods: Using the LAC+USC/Keck Medical Center PCI database, chart review of 3850 patients receiving PCI revealed 211 with AF who met indication for AC given CHADS2-VASc≥2. The discharge AC regimen of each patient was evaluated to assess for correlation of CHADS2-VASc, prior AC and CVA history to AC post PCI.
Results: Of 211 patients indicated for AC, 104 (49.2%) were placed on AC post PCI, while 97 (46%) were placed on dual antiplatelet therapy. If a patient was admitted on AC, they were more likely to be discharged with AC (r= 0.54, p value=<0.0001). Neither CVA history (r=0.10, p=0.14) nor CHADS2-VASc (r=0.05, p=0.44) correlated to AC post PCI. The percentage of patients discharged on AC by CHADS2-VASc score is shown in Figure 1.
Conclusions: Only half of patients indicated for AC with AF post PCI are discharged on appropriate therapy. Patients are more likely to be on AC if present on admission. History of CVA and CHADS2-VASc fail to correlate with AC, suggesting need for greater physician education regarding the relative risks of TE in this population.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Arrhythmias and Clinical EP: Anticoagulation Issues
Abstract Category: 6. Arrhythmias and Clinical EP: Other
Presentation Number: 1189-092
- 2017 American College of Cardiology Foundation