摘要
Abstract
Objective To investigate the application of antithrombotic therapy and analyze the effect of the antithrombotic treatment with parenteral anticoagulation and dual antiplatelet therapy (DT; aspirin+clopidogrel/ticagrelor) in hospitalized patients with acute myocardial infarction (AMI) and non-valvular atrial ifbrillation (NVAF) retrospectively. <br> Methods A total of 143 hospitalized patients who was admitted with AMI and diagnosed with NVAF within 1 month before admission between Jan 2010 and Dec 2015 in Department of Neurology of Beijing Anzhen Hospital were included in this study. The antithrombotic therapy information during hospitalization period and on discharge were investigated. Patients recevied DT during hospitalization period were divided into DT group (n=33) while patients recevied parenteral anticoagulation combined with DT were divided into TT group (triple antithrombotic therapy, n=102). The bleeding events according to the bleeding academic research criteria (BARC) and ischemic events (ie, ischemic stroke, recurrent acute coronary artery syndrome, peripheral arterialembolization) were compared between the two groups. <br> Results①Only 12.6% (18/143) of these 143 selected patients with NVAF were taking warfarin before their AMI admission. During hospitalization period, 71.3% (102/143) of those received parenteral anticoagulation combined with DT and there were some patients who didn’t receive any anticoagulant therapy, among which, DT accounted for 23.1% (33/143), and single antiplatelet therapy (ST; aspirin/clopidogrel/ticagrelor) accounted for 2.1% (3/143). On discharge, more than 2/3 patients received DT, accounting for 76.9% (103/134), and only 4.5% (6/134) received warfarin combined with DT.②During hospitalization period, the rate of total bleeding events (BARC 2-5), major bleeding events (BARC 3, 5) and minor bleeding events (BARC 2) were lower (3.0%vs 7.8%, 0vs 1.0%, 3.0%vs 6.9%), however, the rate of total ischemic events, ischemic stroke, peripheral arterial embolism rate were higher (6.1%vs 3.9%, 6.1%vs 1.0%, 3.0%vs 0) in DT group compared with TT group, while there was no signiifcant difference between the two groups (P>0.05). <br> Conclusion This study suggests that there are some patients who don’t received any anticoagulant therapy, and the parenteral anticoagulation combined with dual antiplatelet therapy does not significantly reduce the thrombotic events and increase the hemorrhagic events during hospitalization in patients with AMI and NVAF. What’s more, the proportion of the triple antithrombotic therapy as secondary prevention is very low in patients with AMI and NVAF.关键词
非瓣膜性心房颤动/急性心肌梗死/抗栓治疗/三重抗栓治疗Key words
Non-valvular atrial fibrillation/Acute myocardial infarction/Antithrombotic therapy/Triple antithrombotic therapy
