Abstract：Objective To retrospectively observe the efficacy and safety of anticoagulation therapy on patients with atrial fibrillation(AF) undergoing percutaneous coronary intervention(PCI). Methods A total of 401 patients who had undergone PCI in the Ninth People’s Hospital of Zhengzhou from January 2008 to April 2015 were enrolled in our study. There were 64 cases complicating AF among them, with 39 males and 25 females at an average age of (66.2±11.0) years old. There were divided into three groups by medication treatment: Group 1(aspirin plus clopidogrel) with 16 cases, Group 2(aspirin plus warfarin) with 27 cases and Group 3(aspirin plus clopidogrel plus warfarin) with 21 cases. The mean followup duration was (8.4±2.6) months. The safety of anticoagulation therapy was observed according to the definition of hemorrhoea by ISTH standard, and TIMI and GUSTO grading criteria for bleeding. And the efficacy of the treatment was evaluated on the basis of major adverse cardiovascular events(MACEs). Results In Group 1, 0% of subjects reached a major safety endpoint for clinically significant bleeding while the proportion was 0% and 52.4% separately in Group 2 and 3. In Group 1, 0% of subjects had clinically relevant nonsignificant bleeding while the proportion was 29.6% and 4.8% separately in Group 2 and 3. There were all statistically significant differences among the three groups(P<0.001). Two cases of cardiac death were observed during treatment, accounting for 3.1% of the total observed population while 8 patients with acute myocardial infarction and 19 patients with stroke and(or) angina were readmitted to hospital. MACEs occurred in 43.75% of patients in Group 1, 44.4% in Group 2 and 47.6% in Group 3, with no statistically significant differences among the three groups(P=0.843). Conclusion Compared with dual antiplatelet therapy and aspirin plus warfarin treatment, traditional tripledose anticoagulation therapy has a high risk of clinically significant bleeding for AF patients implanted with PCI stent, and the incidences of MACEs are similar. For AF patients implanted with PCI stent, the incidence of clinical bleeding could be expected to fall with a strategy of anticoagulant therapy based on risk assessment.
王晋华, 李玲. 心房颤动PCI术后患者抗凝治疗的有效性和安全性研究[J]. 实用心电学杂志, 2017, 26(2): 125-128.
WANG Jin-Hua, LI Ling. The efficacy and safety of anticoagulant therapy on atrial fibrillation patients after PCI. JOURNAL OF PRACTICAL ELECTROCARDIOLOGY, 2017, 26(2): 125-128.
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