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Long-term mortality of patients with atrial fibrillation undergoing percutaneous coronary intervention with stent implantation for acute and stable coronary artery disease.

Publication ,  Journal Article
Rohla, M; Vennekate, CK; Tentzeris, I; Freynhofer, MK; Farhan, S; Egger, F; Weiss, TW; Wojta, J; Granger, CB; Huber, K
Published in: Int J Cardiol
April 1, 2015

BACKGROUND: Patients with atrial fibrillation (AF) are of increased risk for ischemic and bleeding complications, particularly when requiring aggressive antithrombotic therapy after coronary stenting. However, data from unselected patients on long-term mortality are scarce. METHODS: We analyzed 2890 patients of a single-center registry undergoing coronary stenting between 2003 and 2012, of whom 1434 patients had stable coronary artery disease (CAD), while 1456 patients presented with acute coronary syndromes (ACS). As the primary endpoint, we compared long-term all-cause mortality between patients with AF and patients in sinus rhythm. RESULTS: History or presence of AF was found in 146 (10.2%) patients with stable CAD and 93 (6.4%) patients with ACS. The median CHA2DS2-VASc scores were similar between stable CAD and ACS patients (4[2; 5] vs. 3[2; 5], p=0.92). Patients with AF had a significantly higher atherothrombotic risk profile and more co-morbidities. Patients undergoing PCI before 2011 received triple therapy (aspirin, clopidogrel and a vitamin K antagonist) in 25% of cases, compared to 64% of cases thereafter. Patients undergoing elective or urgent revascularization and suffering from AF had a similar 2-fold increased adjusted relative risk of death after a mean follow-up of 4.8 years (HR 1.95, 95% CI 1.27; 2.99, p<0.01 for stable CAD and HR 1.95, 95% CI 1.23; 3.11, p<0.01 for ACS). CONCLUSION: In a general practice setting, patients with AF had significantly increased adjusted long-term mortality than patients without AF. After publication of the consensus document of different working groups of the European Society of Cardiology in 2010, triple therapy increased markedly.

Duke Scholars

Published In

Int J Cardiol

DOI

EISSN

1874-1754

Publication Date

April 1, 2015

Volume

184

Start / End Page

108 / 114

Location

Netherlands

Related Subject Headings

  • Treatment Outcome
  • Stents
  • Risk Factors
  • Registries
  • Percutaneous Coronary Intervention
  • Mortality
  • Middle Aged
  • Male
  • Humans
  • Female
 

Citation

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ICMJE
MLA
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Rohla, M., Vennekate, C. K., Tentzeris, I., Freynhofer, M. K., Farhan, S., Egger, F., … Huber, K. (2015). Long-term mortality of patients with atrial fibrillation undergoing percutaneous coronary intervention with stent implantation for acute and stable coronary artery disease. Int J Cardiol, 184, 108–114. https://doi.org/10.1016/j.ijcard.2015.02.004
Rohla, Miklos, Christoph Kleine Vennekate, Ioannis Tentzeris, Matthias K. Freynhofer, Serdar Farhan, Florian Egger, Thomas W. Weiss, Johann Wojta, Christopher B. Granger, and Kurt Huber. “Long-term mortality of patients with atrial fibrillation undergoing percutaneous coronary intervention with stent implantation for acute and stable coronary artery disease.Int J Cardiol 184 (April 1, 2015): 108–14. https://doi.org/10.1016/j.ijcard.2015.02.004.
Rohla M, Vennekate CK, Tentzeris I, Freynhofer MK, Farhan S, Egger F, et al. Long-term mortality of patients with atrial fibrillation undergoing percutaneous coronary intervention with stent implantation for acute and stable coronary artery disease. Int J Cardiol. 2015 Apr 1;184:108–14.
Rohla, Miklos, et al. “Long-term mortality of patients with atrial fibrillation undergoing percutaneous coronary intervention with stent implantation for acute and stable coronary artery disease.Int J Cardiol, vol. 184, Apr. 2015, pp. 108–14. Pubmed, doi:10.1016/j.ijcard.2015.02.004.
Rohla M, Vennekate CK, Tentzeris I, Freynhofer MK, Farhan S, Egger F, Weiss TW, Wojta J, Granger CB, Huber K. Long-term mortality of patients with atrial fibrillation undergoing percutaneous coronary intervention with stent implantation for acute and stable coronary artery disease. Int J Cardiol. 2015 Apr 1;184:108–114.
Journal cover image

Published In

Int J Cardiol

DOI

EISSN

1874-1754

Publication Date

April 1, 2015

Volume

184

Start / End Page

108 / 114

Location

Netherlands

Related Subject Headings

  • Treatment Outcome
  • Stents
  • Risk Factors
  • Registries
  • Percutaneous Coronary Intervention
  • Mortality
  • Middle Aged
  • Male
  • Humans
  • Female