Antithrombotic Management of Atrial Fibrillation After Percutaneous Coronary Intervention Over 10 Years: Evolution and Guidelines Uptake

Beaulieu, Marie-Claude; Proulx, Laurie-Anne Boivin; Mansour, Samer; Matteau, Alexis; Gobeil, François; Potter, Brian J.

doi:10.1016/s0735-1097(21)01461-3

Cited by 1 publication

(2 citation statements)

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“…In this context, large-scale observational clinical studies are strongly awaited to confirm in a 'realworld' setting what is recommended in the guidelines. Currently, all published prospective studies on this topic [13][14][15][16][17][18][19][20][21][22] enrolled a small number of patients that limits the possibility of reliable analyses on hard clinical end points.…”

Section: Discussionmentioning

confidence: 99%

“…In this context, large-scale observational clinical studies are strongly awaited to confirm in a ‘real-world’ setting what is recommended in the guidelines. Currently, all published prospective studies on this topic 13–22 enrolled a small number of patients that limits the possibility of reliable analyses on hard clinical end points. Only recently, a large prospective study 23 enrolling more than 1000 patients has been published showing a significant reduction in clinically relevant bleeding with DAT compared with TAT but a trend towards a higher risk of major adverse cardiovascular events (12.4 versus 9.6%, P = 0.17).…”

Section: Discussionmentioning

confidence: 99%

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Design of the PERSEO Registry on the management of patients treated with oral anticoagulants and coronary stent

Sciahbasi

Gargiulo

Talarico

et al. 2022

Journal of Cardiovascular Medicine

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AimPercutaneous coronary intervention with stent implantation (PCI-S) in patients requiring chronic oral anticoagulant therapy (OAC) is associated with an increased risk of bleeding and ischemic complications. Different randomized studies showed a significant advantage of a double antithrombotic therapy and superiority of direct oral anticoagulant (DOAC) compared with warfarin, but real-world data are limited. Aim is to evaluate the antithrombotic management and clinical outcome of patients with an indication for OAC who undergo PCI-S in a ‘real-world’ setting.MethodsThe multicentre prospective observational PERSEO (PERcutaneouS coronary intErventions in patients treated with Oral anticoagulant therapy) Registry (ClinicalTrials.gov Identifier: NCT03392948) has been designed to enrol patients requiring OAC treated by PCI-S in 25 Italian centres. A target of at least 1080 patients will be followed for 1 year and data on thromboembolic and bleeding events and changes in antithrombotic therapy will be registered. The primary end point is a combined measure of efficacy and safety outcome (NACE), including major bleeding events and major adverse cardiac and cerebral events at 1-year follow-up in patients treated with DOAC (and dual or triple antiplatelet therapy) compared with the corresponding strategies with vitamin K antagonists. A secondary prespecified analysis has been defined to evaluate NACE in dual versus triple antithrombotic therapy after hospital discharge at 1-year follow-up.ConclusionThe PERSEO Registry will investigate in a ‘real world’ setting the safety and efficacy of DOAC versus warfarin and dual versus triple antithrombotic therapy in patients with indication for oral anticoagulant therapy who undergo PCI-S.

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