Antithrombotic Therapy and Outcomes of Patients With New-Onset Transient Atrial Fibrillation After ST-Segment Elevation Myocardial Infarction

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dc.authoridKeskin, Muhammed/0000-0002-4938-0097
dc.authorwosidKeskin, Muhammed/W-8229-2018
dc.contributor.authorKayapinar, Osman
dc.contributor.authorKaya, Adnan
dc.contributor.authorKeskin, Muhammed
dc.contributor.authorTatlisu, Mustafa Adem
dc.date.accessioned2021-12-01T18:48:59Z
dc.date.available2021-12-01T18:48:59Z
dc.date.issued2021
dc.department[Belirlenecek]en_US
dc.description.abstractBackground: Atrial fibrillation (AF) is a common complication of ST-segment elevation myocardial infarction (STEMI), and AF might require anticoagulant treatment in some conditions. Study Question: There are no clear recommendations about vitamin K antagonist (VKA) use in patients with STEMI who complicated with new-onset transient AF. In this study, we examined the association of concomitant use of VKA and dual antiplatelet therapy (DAPT) with clinical outcomes of this patient population. Study Design: A total of 4086 patients with STEMI who underwent primary percutaneous coronary intervention retrospectively investigated. Among these patients, a total of 286 patients who developed new-onset transient AF during hospitalization were enrolled. VKA group consisted of 116 patients treated with warfarin, aspirin, and clopidogrel, and DAPT group consisted of 170 patients treated with aspirin and clopidogrel. Measures and Outcomes: One-year mortality, ischemic stroke, major, and minor bleeding were determined as clinical outcomes. Results: Although VKA group had proportionally lower mortality (17.2% vs. 20.0%) and ischemic stroke (7.8% vs. 11.8%) compared with DAPT group, the differences did not reach to statistical significance, whereas the 1-year major bleeding had higher rates at VKA group and that had 3.5-times higher major bleeding than DAPT group. This relationship was persisted after multivariable analysis (hazard ratio = 3.37, 95% CI, 1.76-10.04, P = 0.012). Conclusions: There is not a widely accepted treatment algorithm in patients with STEMI who complicated with new-onset AF in clinical guidelines. The current study indicated that transient form of new-onset AF might not require long-term VKA. Besides, addition of VKA to DAPT therapy may increase the rates of major and minor bleeding.en_US
dc.identifier.doi10.1097/MJT.0000000000000858
dc.identifier.endpageE40en_US
dc.identifier.issn1075-2765
dc.identifier.issn1536-3686
dc.identifier.issue1en_US
dc.identifier.pmid30299271en_US
dc.identifier.scopus2-s2.0-85064248065en_US
dc.identifier.scopusqualityQ2en_US
dc.identifier.startpageE30en_US
dc.identifier.urihttps://doi.org/10.1097/MJT.0000000000000858
dc.identifier.urihttps://hdl.handle.net/20.500.12684/10642
dc.identifier.volume28en_US
dc.identifier.wosWOS:000607300600004en_US
dc.identifier.wosqualityQ3en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakPubMeden_US
dc.indekslendigikaynakScopusen_US
dc.language.isoenen_US
dc.publisherLippincott Williams & Wilkinsen_US
dc.relation.ispartofAmerican Journal Of Therapeuticsen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectnew-onset atrial fibrillationen_US
dc.subjectST-segment elevation myocardial infarctionen_US
dc.subjectvitamin K antagonisten_US
dc.subjectbleedingen_US
dc.subjectstrokeen_US
dc.titleAntithrombotic Therapy and Outcomes of Patients With New-Onset Transient Atrial Fibrillation After ST-Segment Elevation Myocardial Infarctionen_US
dc.typeArticleen_US

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