Unique ID issued by UMIN | UMIN000047503 |
---|---|
Receipt number | R000054173 |
Scientific Title | Investigation of the effect of dual antithrombotic therapy with prasugrel in patients with atrial fibrillation after drug-eluting stent implantation for coronary artery disease |
Date of disclosure of the study information | 2022/04/18 |
Last modified on | 2024/04/17 11:47:56 |
Investigation of the effect of dual antithrombotic therapy with prasugrel in patients with atrial fibrillation after drug-eluting stent implantation for coronary artery disease
CHIBA AF-PCI registry
Investigation of the effect of dual antithrombotic therapy with prasugrel in patients with atrial fibrillation after drug-eluting stent implantation for coronary artery disease
CHIBA AF-PCI registry
Japan |
Atrial fibrillation
Coronary artery disease
Cardiology |
Others
NO
To investigate the safety and efficacy of dual antithrombotic therapy with oral anticoagulant and prasugrel in patients with atrial fibrillation and coronary artery disease undergoing parcutaneous coronary intervention.
Safety,Efficacy
Major adverse cardiovascular events (all-cause death, non-fatal myocardial infarction, stent thrombosis, unplanned revascularization, stroke)
Observational
20 | years-old | <= |
85 | years-old | >= |
Male and Female
1) patients with non-valvular atrial fibrillation requiring anticoagulant therapy.
2) patients with coronary artery disease undergoing percutaneous coronary intervention.
1. PCI with two stent technique for bifurcation lesion
2. history of stent thrombosis
3. mechanical valve or bioprosthetic valve
4. cardiogenic shock
5. history of stroke, major surgery, gastrointestinal bleeding within 1 month
6. hemorrhagic disease or diathesis
7. severe renal dysfunction
8. severe lever dysfunction
9. allergy for warfarin, dabigatran, rivaroxaban, apixaban, edoxaban, or prasugrel
10. pregnancy
11. scheduled for surgery
400
1st name | Yoshio |
Middle name | |
Last name | Kobayashi |
Chiba University Graduate School of Medicine
Department of Cardiovascular Medicine
260-8677
1-8-1 Inohana Chuo-ku, Chiba
043-222-7171
yoshio.kobayashi@wonder.ocn.ne.jp
1st name | Hideki |
Middle name | |
Last name | Kitahara |
Chiba University Graduate School of Medicine
Department of Cardiovascular Medicine
260-8677
1-8-1 Inohana Chuo-ku, Chiba
043-222-7171
hidekitahara0306@gmail.com
Chiba University
Chiba University Graduate School of Medicine
Self funding
Chiba University Graduate School of Medicine
1-8-1 Inohana Chuo-ku, Chiba
043-222-7171
prc-jim@chiba-u.jp
NO
2022 | Year | 04 | Month | 18 | Day |
https://www.sciencedirect.com/science/article/pii/S0914508723001387?via%3Dihub
Published
https://www.sciencedirect.com/science/article/pii/S0914508723001387?via%3Dihub
949
In AF patients undergoing PCI, DAT was associated with lower incidence of MACE and major bleed- ing events compared with TAT. In comparison of P2Y12i, there might be no significant difference in the incidence of MACE and bleeding events between prasugrel-based DAT and clopidogrel-based DAT.
2024 | Year | 04 | Month | 17 | Day |
Patients with AF requiring OAC therapy undergoing PCI using drug-eluting stents (DES) for coronary artery disease between January 2015 and March 2021 were screened. Main exclusion criteria were as follows: PCI with two stent technique for bifurcation lesion, history of stent thrombosis, mechanical or bioprosthetic valve, cardiogenic shock, and severe liver dysfunction. Then, a total of 949 patients were registered in this study. Patients with OAC for any indication other than AF (n = 11), no DES implantation (n = 25), lack of PCI information (n = 3), no OAC administration (n = 134), and no follow-up data after discharge (n = 30) were excluded. Furthermore, in 746 AF patients with antithrombotic therapy after PCI using DES, patients who changed from TAT to OAC alone within 1 month for no particular reason (n = 2), change in a P2Y12i during the follow-up (n = 17), and cessation of OAC without any clinical events (n = 17) were also excluded. Consequently, 710 patients were eligible for analysis in the present study.
The regimen and duration of antithrombotic therapies were at the discretion of attending physicians after assessment of each individual's thrombotic and bleeding risk. Patients with DAT from the time of PCI throughout the study period and those with very short-term TAT within 1 month followed by DAT were included in the DAT groups. Patients were first divided into 2 groups according to the regimen of antithrombotic therapy: DAT with P2Y12i and the remaining TAT groups. And then, patients in the DAT group were divided into 2 groups according to the type of P2Y12i for further analysis: prasugrel-based DAT (prasugrel-DAT) and clopidogrel-based DAT (clopidogrel-DAT) groups. In this analysis, the clopidogrel-DAT group included acute coronary syndrome patients receiving a loading dose of prasugrel which was then switched to maintenance dose of clopidogrel in the sub-acute phase after PCI.
The primary endpoint in the present study was cumulative incidence of major adverse cardiovascular events (MACE), a composite of all-cause death, non-fatal myocardial infarction, stent thrombosis, unplanned revascularization, and stroke within 1 year after PCI. The secondary safety endpoint was cumulative incidence of major bleeding events, defined as Bleeding Academic Research Consortium (BARC) types 3 and 5, within 1 year after PCI.
The primary endpoint in the present study was cumulative incidence of major adverse cardiovascular events (MACE), a composite of all-cause death, non-fatal myocardial infarction, stent thrombosis, unplanned revascularization, and stroke within 1 year after PCI. The secondary safety endpoint was cumulative incidence of major bleeding events, defined as Bleeding Academic Research Consortium (BARC) types 3 and 5, within 1 year after PCI.
Completed
2019 | Year | 10 | Month | 15 | Day |
2019 | Year | 07 | Month | 09 | Day |
2019 | Year | 10 | Month | 15 | Day |
2022 | Year | 03 | Month | 31 | Day |
In this observational study, patients were prospectively and retrospectively enrolled.
2022 | Year | 04 | Month | 16 | Day |
2024 | Year | 04 | Month | 17 | Day |
Value
https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000054173