Effect of anticoagulant therapy regimen for patients with atrial fibrillation complicated with acute coronary syndrome undergoing coronary stent implantation

Abstract

Objective To evaluate the effect of different anticoagulant therapy regimens in patients with atrial fibrillation complicated with acute coronary syndrome undergoing stent implantation. Methods This was a retrospective cohort study. Patients with acute coronary syndrome and atrial fibrillation undergoing PCI in our hospital from January 2014 to January 2017 were selected. Based on the anticoagulant regimen, all patients were divided into two groups: triple anticoagulant group (treated with warfarin, aspirin and clopidogrel, as TT group) and dual anticoagulant group (treated with warfarin and clopidogrel, as WC group). We compared the safety (risk of major bleeding) and efficacy (major adverse cardiac and cerebrovascular event, MACCE) between the two groups after 12-month follow-up. Results Overall, 212 patients were enrolled in the study, with 113 males, the average age of (56.1±12.4) years. There were 139 patients in the TT group, and 73 patients in the WC group. There was no significant difference in anticoagulant duration, thrombotic risk, bleeding risk, stent types and peak value of CK-MB 24 h post-PCI (all P>0.05). After follow-up of (12.3±1.2) months, the incidence of bleeding in the TT group were significantly higher than that in the WC group (P 0.05). Conclusions For patients with acute coronary syndrome and atrial fibrillation undergoing stent implantation, dual anticoagulant therapy with warfarin and clopidogrel is a safe and effective anticoagulant regimen, with decreased risk of bleeding and comparable rate of adverse cardiac and cerebrovascular event. Key words: Anticoagulant therapy; Acute coronary syndrome; Atrial fibrillation; Bleeding; Adverse cardiac and cerebrovascular events