- NEWS . 02 Nov 2020
Real-world data showing a shift in preference towards NOACs and aspirin-free antiplatelet strategy
A recent study investigating ‘real-world’ trends of antithrombotic treatment strategies in patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI) revealed a strong shift towards the use of non-vitamin K antagonist oral anticoagulants (NOACs) rather than vitamin K antagonists (VKAs), along with a large subset of patients adopting an aspirin-free strategy early after index PCI.
Data were retrieved from the GReek-AntiPlatElet Atrial Fibrillation (GRAPE-AF) registry, a contemporary, nationwide, multicentre, observational study of patients with AF undergoing PCI. Characteristics of patients discharged on triple antithrombotic therapy (TAT) or dual antithrombotic therapy (DAT) were compared to identify factors that could influence treatment decisions.
Of the 654 patients enrolled (42% with stable coronary artery disease, 58% with acute coronary syndrome), TAT was adopted in 49.9% and DAT in 49.2% at discharge. With regards to anticoagulants, the vast majority of patients (92.9%) received NOACs and only 7.1% received VKAs. Additionally, factors including dyslipidaemia, insulin-dependent diabetes mellitus, prior myocardial infarction, acute coronary syndrome at presentation and regional variations were predictive of TAT adoption, whereas the use of NOACs or ticagrelor was predictive of DAT adoption; ticagrelor was used in almost one quarter of cases, as part of a DAT regimen, among PCI-treated ACS patients with AF.
Benetou DR, et al. Trends of antithrombotic treatment in atrial fibrillation patients undergoing percutaneous coronary intervention: Insights from the GReek-AntiPlatElet Atrial Fibrillation (GRAPE-AF) registry. Cardiovasc Drugs Ther 2020. doi: 10.1007/s10557-020-07090-x. [Epub ahead of print].