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• W2166609164 abstract "Among patients with atrial fibrillation (AF) treated with oral anticoagulation (OAC) for stroke prevention, concomitant use of antiplatelet (AP) agents increases bleeding risk. Also, when compared to OAC alone, additional AP use confers uncertain benefits in terms of reduction of ischemic vascular events. Since little is known regarding the factors which influence the use of OAC+AP vs. OAC alone in current clinical practice, we sought to identify them in a contemporary, national, observational registry. From December 2012 to July 2013, a cross-sectional analysis of 850 consecutive AF patients was performed. They were enrolled from 101 practices in 7 Canadian provinces. Demographics of patients treated with OAC+AP (primarily aspirin) vs. OAC alone were identified. Multivariable logistic regression was performed to identify factors associated with OAC+AP vs. OAC use. Seven hundred and five (87%) patients were treated with OAC, amongst whom 135 (19%) were treated with OAC+AP and 570 (81%) were treated with OAC alone. Amongst patients treated with OAC+AP, 58 (43%) did not have a known history of coronary artery disease (CAD) (defined as presence of stable CAD, acute coronary syndrome, percutaneous coronary intervention (PCI), or coronary artery bypass surgery) or peripheral arterial disease (PAD). In the OAC+AP group, 38 (28%) patients had PCI and 51 (38%) patients had diabetes. Patients treated with OAC+AP vs. OAC alone did not significantly differ in age: 77.5 (71.4, 82.3) vs. 76.9 (69.0, 83.0) years (median, IQR). On univariable analysis, male sex, dyslipidemia, PAD, non-CNS systemic embolism, and CAD were associated with OAC+AP use (vs. OAC alone). On multivariable analysis, CAD (OR 4.20, 95% CI 2.83 to 6.24, p<0.01) and male sex (OR 1.60, 95% CI 1.01 to 2.61, p=0.047) were associated with OAC+AP use. In this contemporary registry of AF patients treated with OAC for stroke prevention, we found that 1 in 5 patients was treated with OAC+AP. Although a history of CAD was associated with OAC+AP use, a substantial proportion of patients in this subgroup did not have compelling indications for being treated with AP agents (e.g. history of PCI). Since OAC+AP use increases bleeding risk without discernible benefits in stroke or myocardial infarction reduction, the relatively high rate of AP co-prescription in OAC-treated AF patients represents a potential practice gap. Efforts are needed to address this practice pattern to minimize the over-prescription of AP agents in this patient population." @default.
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• W2166609164 date "2014-10-01" @default.
• W2166609164 modified "2023-09-27" @default.
• W2166609164 title "HIGH RATES OF CONCOMITANT ANTIPLATELET USE IN PATIENTS WITH ATRIAL FIBRILLATION TREATED WITH ORAL ANTICOAGULATION: INSIGHTS FROM THE STROKE PREVENTION AND RHYTHM INTERVENTIONS IN ATRIAL FIBRILLATION (SPRINT-AF) REGISTRY" @default.
• W2166609164 doi "https://doi.org/10.1016/j.cjca.2014.07.289" @default.
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