Longitudinal Patterns in Antithrombotic Therapy in Patients with Atrial Fibrillation after Percutaneous Coronary Intervention in the Non-Vitamin K Oral Anticoagulant Era: A Nationwide Population-Based Study
- Authors
- Park, Jiesuck; Jung, Jin-Hyung; Choi, Eue-Keun; Lee, Seung-Woo; Kwon, Soonil; Lee, So-Ryoung; Kang, Jeehoon; Han, Kyung-Do; Park, Kyung-Woo; Oh, Seil; Lip, Gregory Y. H.
- Issue Date
- Apr-2021
- Publisher
- MDPI
- Keywords
- atrial fibrillation; percutaneous coronary intervention; anticoagulation; antiplatelets; non-vitamin K oral anticoagulant
- Citation
- JOURNAL OF CLINICAL MEDICINE, v.10, no.7
- Journal Title
- JOURNAL OF CLINICAL MEDICINE
- Volume
- 10
- Number
- 7
- URI
- http://scholarworks.bwise.kr/ssu/handle/2018.sw.ssu/41996
- DOI
- 10.3390/jcm10071505
- ISSN
- 2077-0383
- Abstract
- We investigated whether longitudinal patterns in antithrombotic therapy have changed after the introduction of non-vitamin K oral anticoagulants (NOACs) in patients with atrial fibrillation (AF) who underwent percutaneous coronary intervention (PCI). Using a claims database of the Korean AF population who underwent PCI between 2012 and 2016 (n = 18,691), we analyzed prescription records of oral anticoagulants (OACs) and antiplatelets at 3-month intervals over 2 years after PCI. The study population was stratified (pre-NOAC, transition, and NOAC era) using time-periods of NOAC introduction in Korea and an expansion of reimbursement for NOAC in AF as indicators. The overall rates of OAC were low at baseline (24.9%, 26.9%, and 35.2% in pre-NOAC, transition, and NOAC era, respectively), contrary to high rates of dual antiplatelet therapy (DAPT) (73.3%, 71.4%, and 63.6%). However, OAC prescription rates were increased at 1-year (18.5%, 22.5%, and 31.6%), and 2-year follow-up (17.8%, 24.2%, and 31.8%) from pre-NOAC to NOAC era. In NOAC era, 63.5% of baseline OAC prescriptions comprised NOAC, of which 96.4% included triple therapy with DAPT. Over 2 years, we observed increasing rates of double therapy with a single antiplatelet (18.3% and 20.0% at 1- and 2-year follow-up) and OAC monotherapy (2.7% and 8.9% at 1- and 2-year follow-up).
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Collections - College of Natural Sciences > ETC > 1. Journal Articles
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