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Usefulness of Antithrombotic Therapy in Patients With Atrial Fibrillation and Acute Myocardial Infarction.

Publication ,  Journal Article
Guimarães, PO; Zakroysky, P; Goyal, A; Lopes, RD; Kaltenbach, LA; Wang, TY
Published in: Am J Cardiol
January 1, 2019

To examine patterns of preadmission and discharge antithrombotic therapies in coronary artery disease (CAD) and atrial fibrillation (AF) patients admitted for acute myocardial infarction (AMI), we performed a retrospective analysis of the Acute Coronary Treatment and Intervention Outcomes Network Registry-Get With the Guidelines (ACTION Registry-GWTG), which captures consecutive AMI patients treated at participating US hospitals. We included patients with CAD, AF, and CHA2DS2-VASc score ≥2 admitted for AMI (07/01/2013-09/30/2016). In the 15,034 AMI patients with previous AF and CAD, median age was 75; 32% were female. Preadmission, 32% of patients were on P2Y12 inhibitors, 36% were anticoagulated, 72% were on aspirin, and 5% were on triple therapy. At discharge post-AMI, 73% were prescribed P2Y12 inhibitors and 41% anticoagulation. Discharge anticoagulation use did not vary directly with CHA2DS2-VASc score; 16% of previously anticoagulated patients had discontinued anticoagulation at discharge. In patients receiving anticoagulants at discharge, 27% used nonvitamin K antagonist oral anticoagulants. Triple therapy was prescribed in 23% at discharge; 27% of these were with nonvitamin K antagonist oral anticoagulants and 14% with prasugrel or ticagrelor. P2Y12 inhibitors and anticoagulants without aspirin were used in 2%. In conclusion, patients with previous CAD and AF are undertreated for both recurrent ischemic events and stroke prevention. After AMI hospitalization, P2Y12 inhibition was preferentially selected over oral anticoagulation.

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Published In

Am J Cardiol

DOI

EISSN

1879-1913

Publication Date

January 1, 2019

Volume

123

Issue

1

Start / End Page

12 / 18

Location

United States

Related Subject Headings

  • United States
  • Stroke
  • Retrospective Studies
  • Registries
  • Myocardial Infarction
  • Male
  • Humans
  • Fibrinolytic Agents
  • Female
  • Coronary Artery Disease
 

Citation

APA
Chicago
ICMJE
MLA
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Guimarães, P. O., Zakroysky, P., Goyal, A., Lopes, R. D., Kaltenbach, L. A., & Wang, T. Y. (2019). Usefulness of Antithrombotic Therapy in Patients With Atrial Fibrillation and Acute Myocardial Infarction. Am J Cardiol, 123(1), 12–18. https://doi.org/10.1016/j.amjcard.2018.09.031
Guimarães, Patrícia O., Pearl Zakroysky, Abhinav Goyal, Renato D. Lopes, Lisa A. Kaltenbach, and Tracy Y. Wang. “Usefulness of Antithrombotic Therapy in Patients With Atrial Fibrillation and Acute Myocardial Infarction.Am J Cardiol 123, no. 1 (January 1, 2019): 12–18. https://doi.org/10.1016/j.amjcard.2018.09.031.
Guimarães PO, Zakroysky P, Goyal A, Lopes RD, Kaltenbach LA, Wang TY. Usefulness of Antithrombotic Therapy in Patients With Atrial Fibrillation and Acute Myocardial Infarction. Am J Cardiol. 2019 Jan 1;123(1):12–8.
Guimarães, Patrícia O., et al. “Usefulness of Antithrombotic Therapy in Patients With Atrial Fibrillation and Acute Myocardial Infarction.Am J Cardiol, vol. 123, no. 1, Jan. 2019, pp. 12–18. Pubmed, doi:10.1016/j.amjcard.2018.09.031.
Guimarães PO, Zakroysky P, Goyal A, Lopes RD, Kaltenbach LA, Wang TY. Usefulness of Antithrombotic Therapy in Patients With Atrial Fibrillation and Acute Myocardial Infarction. Am J Cardiol. 2019 Jan 1;123(1):12–18.
Journal cover image

Published In

Am J Cardiol

DOI

EISSN

1879-1913

Publication Date

January 1, 2019

Volume

123

Issue

1

Start / End Page

12 / 18

Location

United States

Related Subject Headings

  • United States
  • Stroke
  • Retrospective Studies
  • Registries
  • Myocardial Infarction
  • Male
  • Humans
  • Fibrinolytic Agents
  • Female
  • Coronary Artery Disease