TY - JOUR
T1 - Use of anticoagulants and antiplatelet agents in stable outpatients with coronary artery disease and atrial fibrillation. International CLARIFY registry
AU - CLARIFY Investigators
AU - Fauchier, Laurent
AU - Greenlaw, Nicola
AU - Ferrari, Roberto
AU - Ford, Ian
AU - Fox, Kim M.
AU - Tardif, Jean Claude
AU - Tendera, Michal
AU - Steg, Ph Gabriel
AU - Sokn, Fernando José
AU - Reid, Christopher
AU - Lang, Irene
AU - Van den Branden, Frank
AU - César, Luis Machado
AU - Mattos, Marco Antonio
AU - Nazar Luqman, Hj
AU - Goudev, Assen
AU - Dorian, Paul
AU - Hu, Dayi
AU - Widimsky, Petr
AU - Hassager, Christian
AU - Danchin, Nicolas
AU - Kääb, Stefan
AU - Vardas, Panos
AU - Sulaiman, Kadhim J.
AU - Al Mahmeed, Wael
AU - Al Suwaidi, Jassim
AU - Al Rashdan, Ibrahim
AU - Abdulkader, Fuad
AU - Merkely, Béla
AU - Kaul, Upendra
AU - Daly, Kieran
AU - Tavazzi, Luigi
AU - Zrarizz, R.
AU - Jang, Yangsoo
AU - Erglis, Andrejs
AU - Laucevičius, Aleksandras
AU - Jamaluddin, Ahmad Nizar
AU - Gamba, Marco Alcocer
AU - Tulevski, Igor I.
AU - Stępińska, Janina
AU - Morais, Joao
AU - Macarie, Cezar
AU - Oganov, Rafael
AU - Shalnova, Svetlana
AU - Al-Zaibag, Muayed
AU - Hou, Mak Koon
AU - Kamensky, Gabriel
AU - Fras, Zlatko
AU - Kanič, Vojko
AU - Naidoo, Datshana Prakesh
N1 - Publisher Copyright:
© 2015 Fauchier et al.
PY - 2015
Y1 - 2015
N2 - Background Few data are available regarding the use of antithrombotic strategies in coronary artery disease patients with atrial fibrillation (AF) in everyday practice. We sought to describe the prevalence of AF and its antithrombotic management in a contemporary population of patients with stable coronary artery disease. Methods and Findings CLARIFY is an international, prospective, longitudinal registry of outpatients with stable coronary artery disease, defined as prior (≥12 months) myocardial infarction, revascularization procedure, coronary stenosis >50%, or chest pain associated with evidence of myocardial ischemia. Overall, 33,428 patients were screened, of whom 32,954 had data available for analysis at baseline; of these 2,229 (6.7%) had a history of AF. Median (interquartile range) CHA2DS2-VASc score was 4 (3, 5). Oral anticoagulation alone was used in 25.7%, antiplatelet therapy alone in 52.8% (single 41.8%, dual 11.0%), and both in 21.5%. OAC use was independently associated with permanent AF (p<0.001), CHA2DS2-VASc score (p=0.006), pacemaker (p<0.001), stroke (p=0.04), absence of angina (p=0.004), decreased left ventricular ejection fraction (p<0.001), increased waist circumference (p=0.005), and longer history of coronary artery disease (p=0.008). History of percutaneous coronary intervention (p=0.004) and no/partial reimbursement for cardiovascular medication (p=0.01, p<0.001, respectively) were associated with reduced oral anticoagulant use. Conclusions In this contemporary cohort of patients with stable coronary artery disease and AF, most of whom are theoretical candidates for anticoagulation, oral anticoagulants were used in only 47.2%. Half of the patients received antiplatelet therapy alone and one-fifth received both antiplatelets and oral anticoagulants. Efforts are needed to improve adherence to guidelines in these patients.
AB - Background Few data are available regarding the use of antithrombotic strategies in coronary artery disease patients with atrial fibrillation (AF) in everyday practice. We sought to describe the prevalence of AF and its antithrombotic management in a contemporary population of patients with stable coronary artery disease. Methods and Findings CLARIFY is an international, prospective, longitudinal registry of outpatients with stable coronary artery disease, defined as prior (≥12 months) myocardial infarction, revascularization procedure, coronary stenosis >50%, or chest pain associated with evidence of myocardial ischemia. Overall, 33,428 patients were screened, of whom 32,954 had data available for analysis at baseline; of these 2,229 (6.7%) had a history of AF. Median (interquartile range) CHA2DS2-VASc score was 4 (3, 5). Oral anticoagulation alone was used in 25.7%, antiplatelet therapy alone in 52.8% (single 41.8%, dual 11.0%), and both in 21.5%. OAC use was independently associated with permanent AF (p<0.001), CHA2DS2-VASc score (p=0.006), pacemaker (p<0.001), stroke (p=0.04), absence of angina (p=0.004), decreased left ventricular ejection fraction (p<0.001), increased waist circumference (p=0.005), and longer history of coronary artery disease (p=0.008). History of percutaneous coronary intervention (p=0.004) and no/partial reimbursement for cardiovascular medication (p=0.01, p<0.001, respectively) were associated with reduced oral anticoagulant use. Conclusions In this contemporary cohort of patients with stable coronary artery disease and AF, most of whom are theoretical candidates for anticoagulation, oral anticoagulants were used in only 47.2%. Half of the patients received antiplatelet therapy alone and one-fifth received both antiplatelets and oral anticoagulants. Efforts are needed to improve adherence to guidelines in these patients.
UR - http://www.scopus.com/inward/record.url?scp=84928555753&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0125164
DO - 10.1371/journal.pone.0125164
M3 - Article
C2 - 25915904
AN - SCOPUS:84928555753
SN - 1932-6203
VL - 10
JO - PLoS ONE
JF - PLoS ONE
IS - 4
M1 - e0125164
ER -