CHA2 DS2 -VASc impact on risk following percutaneous coronary intervention in atrial fibrillation

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

DOI

AIMS: In 2010, the European Society of Cardiology Guidelines on atrial fibrillation (AF) introduced the CHA2 DS2 -VASc score to guide initiation of oral anticoagulation. In patients with AF undergoing percutaneous coronary intervention (PCI), triple therapy with oral anticoagulation and dual antiplatelet therapy was recommended to reduce ischemic risk. We examined how the CHA2 DS2 -VASc score impacted oral anticoagulation use and risks of ischemic and hospitalized bleeding events in patients with AF undergoing PCI.

METHODS: We included 6014 patients with AF undergoing first-time PCI in Western Denmark between 2003 and 2017. We divided patients into four groups based on year of PCI and estimated one-year risks of major adverse cardiac events (MACE) and hospitalization for bleeding.

RESULTS: The proportion of oral anticoagulation users was 48% in 2003-2006 and 49% in 2006-2010. Following the CHA2 DS2 -VASc score implementation, the proportion increased to 59% in 2011-2014, and 77% in 2015-2017. Using 2003-2006 as reference, risks of MACE were similar in 2007-2010 (adjusted relative risk [RRadj ] 0.99, 95% confidence interval [CI] 0.83-1.18) and 2011-2014 (RRadj 0.92, 95% CI 0.78-1.09), but declined by 23% in 2015-2017 (RRadj 0.77, 95% CI 0.65-0.92). Hospitalizations for bleeding did not increase despite wider use of triple therapy.

CONCLUSION: Implementation of the CHA2 DS2 -VASc score in the 2010 European guidelines on AF was associated with an increased utilization of oral anticoagulation and triple therapy among AF patients undergoing PCI. These changes were associated with a gradual decline in the risk of MACE, while the risk of hospitalized bleeding remained unchanged.

OriginalsprogEngelsk
TidsskriftEuropean Journal of Clinical Investigation
Sider (fra-til)e13717
ISSN0960-135X
DOI
StatusE-pub ahead of print - 18 nov. 2021

Bibliografisk note

This article is protected by copyright. All rights reserved.

Se relationer på Aarhus Universitet Citationsformater

ID: 226706869