Use of anticoagulants and antiplatelet agents in stable outpatients with coronary artery disease and atrial fibrillation. International clarify registry

Background: Few data are available regarding the use of antithrombotic strategies in coronary artery disease patients with atrial fibrillation (AF) in everyday practice. We sought to describe the prevalence of AF and its antithrombotic management in a contemporary population of patients with stable...

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Elmentve itt :
Bibliográfiai részletek
Szerzők: Fauchier Laurent
Greenlaw Nicola
Ferrari Roberto
Ford Ian
Fox Kim M.
Tardif Jean-Claude
Tendera Michal
Steg Gabriel Ph
CLARIFY Investigators
Jánosi András
Forster Tamás
Merkely Béla Péter
Dokumentumtípus: Cikk
Megjelent: 2015
Sorozat:PLOS ONE 10 No. 4
doi:10.1371/journal.pone.0125164

mtmt:3130766
Online Access:http://publicatio.bibl.u-szeged.hu/18026
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520 3 |a Background: Few data are available regarding the use of antithrombotic strategies in coronary artery disease patients with atrial fibrillation (AF) in everyday practice. We sought to describe the prevalence of AF and its antithrombotic management in a contemporary population of patients with stable coronary artery disease. Methods and Findings: CLARIFY is an international, prospective, longitudinal registry of outpatients with stable coronary artery disease, defined as prior (≥12 months) myocardial infarction, revascularization procedure, coronary stenosis >50%, or chest pain associated with evidence of myocardial ischemia. Overall, 33,428 patients were screened, of whom 32,954 had data available for analysis at baseline; of these 2,229 (6.7%) had a history of AF. Median (interquartile range) CHA<inf>2</inf>DS<inf>2</inf>-VASc score was 4 (3, 5). Oral anticoagulation alone was used in 25.7%, antiplatelet therapy alone in 52.8% (single 41.8%, dual 11.0%), and both in 21.5%. OAC use was independently associated with permanent AF (p<0.001), CHA<inf>2</inf>DS<inf>2</inf>-VASc score (p=0.006), pacemaker (p<0.001), stroke (p=0.04), absence of angina (p=0.004), decreased left ventricular ejection fraction (p<0.001), increased waist circumference (p=0.005), and longer history of coronary artery disease (p=0.008). History of percutaneous coronary intervention (p=0.004) and no/partial reimbursement for cardiovascular medication (p=0.01, p<0.001, respectively) were associated with reduced oral anticoagulant use. Conclusions: In this contemporary cohort of patients with stable coronary artery disease and AF, most of whom are theoretical candidates for anticoagulation, oral anticoagulants were used in only 47.2%. Half of the patients received antiplatelet therapy alone and one-fifth received both antiplatelets and oral anticoagulants. Efforts are needed to improve adherence to guidelines in these patients. Trial Registration: ISRCTN registry of clinical trials: ISRCTN43070564. © 2015 Fauchier et al. 
700 0 1 |a Greenlaw Nicola  |e aut 
700 0 1 |a Ferrari Roberto  |e aut 
700 0 1 |a Ford Ian  |e aut 
700 0 1 |a Fox Kim M.  |e aut 
700 0 1 |a Tardif Jean-Claude  |e aut 
700 0 1 |a Tendera Michal  |e aut 
700 0 1 |a Steg Gabriel Ph.  |e aut 
700 0 1 |a CLARIFY Investigators  |e aut 
700 0 1 |a Jánosi András  |e aut 
700 0 1 |a Forster Tamás  |e aut 
700 0 1 |a Merkely Béla Péter  |e aut 
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