Background
Methods
Study design and population
Data collection
Follow-up and outcomes
Definitions
Statistical analysis
Results
Baseline characteristics
Characteristics | SCAD + AF (n = 559) | ACS + AF (n = 1491) | P-value |
---|---|---|---|
Female, n (%) | 256 (45.80) | 672 (45.07) | 0.064 |
Age, (years) | 71.12 ± 0.86 | 72.34 ± 0.76 | 0.841 |
Smoking, n (%) | 172 (30.77) | 450 (30.18) | 0.796 |
Alcohol drinking history, n (%) | 144 (25.76) | 363(24.35) | 0.509 |
ethanol per person per day, (grams) | 5.12 ± 0.75 | 4.86 ± 0.33 | 0.712 |
Heart failure, n (%) | 62 (11.09) | 193 (12.94) | 0.258 |
Arterial hypertension, n (%) | 388 (69.41) | 1068 (71.63) | 0.324 |
Diabetes mellitus, n (%) | 99 (17.71) | 318 (21.33) | 0.070 |
Hypercholesterolemia, n (%) | 171 (30.59) | 519 (34.81) | 0.072 |
Peptic ulcer, n (%) | 20 (3.58) | 43 (2.88) | 0.418 |
Previous stroke, n (%) | 35 (6.26) | 130 (8.72) | 0.069 |
Previous Bleeding, n (%) | 6 (1.07) | 23 (1.54) | 0.423 |
Previous MI, n (%) | 9 (1.61) | 27 (1.81) | 0.758 |
AF type | |||
Paroxysmal, n (%) | 275 (49.19) | 710 (47.62) | 0.525 |
Persistent, n (%) | 183 (32.74) | 455 (30.52) | 0.334 |
Permanent, n (%) | 101 (18.07) | 326 (21.86) | 0.059 |
CHA2DS2-VASc score | 3.14 ± 1.03 | 3.65 ± 1.22 | 0.422 |
HAS-BLED score | 2.19 ± 1.38 | 2.12 ± 1.11 | 0.696 |
PCI, n (%) | 42 (7.51) | 166 (11.13) | 0.016* |
CABG, n (%) | 3 (0.54) | 18 (1.21) | 0.179 |
ACEI/ARB, n (%) | 357 (63.86) | 993 (66.60) | 0.245 |
β-blocker, n (%) | 374 (66.91) | 1041 (69.82) | 0.204 |
Statins, n (%) | 495 (88.55) | 1288 (86.38) | 0.194 |
Diuretics, n (%) | 81 (14.49) | 207 (13.88) | 0.725 |
Digoxin, n (%) | 91 (16.28) | 287 (19.25) | 0.123 |
CCB, n (%) | 132 (23.61) | 318 (21.33) | 0.266 |
Proton pump inhibitors, n (%) | 315 (56.35) | 863 (57.88) | 0.533 |
INR | 2.16 ± 0.42 | 2.27 ± 0.38 | 0.236 |
Antithrombotic regimen in patients enrolled each year
Antithrombotic strategy at discharge and during follow-up
Clinical complications and the corresponding antithrombotic strategy during follow-up
n (%) | OAC | SAPT | DAPT | DT | TT | P-value | |
---|---|---|---|---|---|---|---|
Ischemic stroke | 23 (1.12) | 4 (0.20) | 12 (0.59) | 6 (0.29) | 1 (0.05) | 0 (0) | |
SCAD+AF | 7 (1.25) | 1 (0.18) | 4 (0.72) | 2 (0.36) | 0 (0) | 0 (0) | |
ACS + AF | 16 (1.07) | 3 (0.20) | 8 (0.54) | 4 (0.27) | 1 (0.07) | 0 (0) | 0.732 |
Bleeding | 93 (4.54) | 14 (0.68) | 7 (0.34) | 20 (0.05) | 23 (1.12) | 29 (1.41) | |
SCAD+AF | 13 (2.33) | 5 (0.89) | 2 (0.36) | 1 (0.18) | 1 (0.18) | 4 (0.72) | |
ACS + AF | 80 (5.37) | 9 (0.60) | 5 (0.34) | 19 (1.27) | 22 (1.48) | 25 (1.68) | 0.003* |
mild bleeding | 59 (2.88) | 11 (0.54) | 6 (0.29) | 12 (0.59) | 16 (0.78) | 14 (0.68) | |
SCAD+AF | 9 (1.61) | 4 (0.72) | 2 (0.36) | 0 (0) | 1 (0.18) | 2 (0.36) | |
ACS + AF | 50 (3.35) | 7 (0.47) | 4 (0.27) | 12 (0.80) | 15 (1.01) | 12 (0.80) | 0.035* |
moderate bleeding | 29 (1.41) | 3 (0.15) | 1 (0.05) | 7 (0.34) | 6 (0.29) | 12 (0.59) | |
SCAD+AF | 3 (0.54) | 1 (0.18) | 0 (0) | 1 (0.18) | 0 (0) | 1 (0.18) | |
ACS + AF | 26 (1.74) | 2 (0.13) | 1 (0.07) | 6 (0.40) | 6 (0.40) | 11 (0.74) | 0.039* |
major bleeding | 5 (0.24) | 0 (0) | 0 (0) | 1 (0.05) | 1 (0.05) | 3 (0.15) | |
SCAD+AF | 1 (0.18) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 1 (0.18) | |
ACS + AF | 4 (0.27) | 0 (0) | 0 (0) | 1 (0.07) | 1 (0.07) | 2 (0.13) | 1.000 |
MI | 19 (0.93) | 7 (0.34) | 5 (0.24) | 2 (0.10) | 3 (0.15) | 2 (0.10) | |
SCAD+AF | 4 (0.72) | 2 (0.36) | 2 (0.36) | 0 (0) | 0 (0) | 0 (0) | |
ACS + AF | 15 (1.01) | 5 (0.34) | 3 (0.20) | 2 (0.13) | 3 (0.20) | 2 (0.13) | 0.725 |
All-cause death | 39 (1.90) | 11 (0.54) | 8 (0.39) | 7 (0.34) | 4 (0.20) | 9 (0.44) | |
SCAD+AF | 5 (0.89) | 1 (0.18) | 2 (0.36) | 0 (0.00) | 1 (0.18) | 1 (0.18) | |
ACS + AF | 34 (2.28) | 10 (0.67) | 6 (0.40) | 7 (0.47) | 3 (0.20) | 8 (0.54) | 0.041* |
Independent predictive factors of adverse outcomes
SCAD + AF | ACS + AF | ||||
---|---|---|---|---|---|
OR (95% CI) | P-value | OR (95% CI) | P-value | ||
Ischemic stroke | Age ≥ 65 | 1.03 (1.01–1.06) | 0.007* | 1.44 (1.06–1.98) | 0.006* |
Female | 1.35 (0.85–1.99) | 0.179 | 1.21 (0.93–1.60) | 0.117 | |
Hypertension | 1.33 (1.04–1.72) | 0.014* | 1.50 (1.22–1.83) | 0.020* | |
Heart failure | 0.99 (0.94–1.03) | 0.225 | 1.26 (0.89–1.78) | 0.193 | |
Diabetes mellitus | 0.62 (0.27–1.46) | 0.214 | 0.92 (0.36–2.27) | 0.890 | |
Previous stroke | 1.39 (1.12–2.17) | 0.009* | 1.25 (1.04–1.56) | 0.031* | |
Previous bleeding | 1.68 (0.77–3.68) | 0.180 | 1.16 (0.57–2.42) | 0.713 | |
Coronary stent | 0.81 (0.31–2.26) | 0.700 | 0.78 (0.37–1.53) | 0.440 | |
OAC | 0.33 (0.25–0.46) | 0.016* | 0.54 (0.30–0.93) | 0.005* | |
APT | 0.72 (0.42–1.10) | 0.113 | 0.88 (0.44–1.65) | 0.637 | |
Bleeding | Age ≥ 65 | 1.29 (0.51–3.35) | 0.587 | 1.85 (1.28–2.66) | 0.020* |
Female | 1.30 (0.57–2.93) | 0.508 | 0.90 (0.76–1.04) | 0.162 | |
Hypertension | 1.10 (0.74–1.63) | 0.482 | 1.14 (0.95–1.33) | 0.148 | |
Heart failure | 1.04 (0.75–1.45) | 0.912 | 0.67 (0.39–1.13) | 0.134 | |
Diabetes mellitus | 0.95 (0.77–1.16) | 0.872 | 1.05 (0.87–1.23) | 0.960 | |
Previous stroke | 1.17 (0.42–3.27) | 0.353 | 1.55 (0.70–3.45) | 0.172 | |
Previous bleeding | 1.85 (1.12–3.07) | 0.001* | 1.78 (1.33–2.39) | 0.006* | |
Coronary stent | 0.67 (0.41–1.11) | 0.621 | 1.34 (0.67–2.70) | 0.316 | |
OAC | 1.17 (0.56–2.25) | 0.658 | 2.28 (0.58–3.91) | 0.243 | |
APT | 1.32 (0.86–2.01) | 0.137 | 2.18 (0.71–6.73) | 0.171 | |
MI | Age ≥ 65 | 1.65 (0.73–3.74) | 0.240 | 1.16 (0.56–2.13) | 0.723 |
Female | 1.55 (0.83–2.91) | 0.133 | 0.93 (0.59–1.46) | 0.738 | |
Hypertension | 1.34 (0.82–2.17) | 0.224 | 2.29 (0.71–7.40) | 0.166 | |
Heart failure | 0.79 (0.40–1.62) | 0.557 | 0.99 (0.91–2.08) | 0.787 | |
Diabetes mellitus | 1.26 (0.60–3.31) | 0.453 | 2.23 (1.75–2.83) | 0.001* | |
Previous stroke | 1.42 (0.82–2.60) | 0.178 | 1.71 (0.69–4.27) | 0.248 | |
Previous bleeding | 1.28 (0.70–2.64) | 0.430 | 1.51 (0.96–2.37) | 0.308 | |
Coronary stent | 1.03 (0.89–1.17) | 0.713 | 0.95 (0.81–1.10) | 0.558 | |
OAC | 0.90 (0.57–1.38) | 0.628 | 1.30 (0.65–2.58) | 0.639 | |
APT | 0.71 (0.58–0.86) | 0.004* | 0.66 (0.56–0.79) | < 0.001* | |
All-cause death | Age ≥ 65 | 1.67 (1.37–2.02) | 0.005* | 1.47 (1.21–1.79) | 0.001* |
Female | 0.85 (0.57–1.28) | 0.470 | 0.93 (0.66–1.37) | 0.750 | |
Hypertension | 1.01 (0.96–1.04) | 0.615 | 1.12 (0.93–1.31) | 0.087 | |
Heart failure | 2.81 (1.82–4.34) | 0.028* | 3.02 (1.61–5.68) | 0.003* | |
Diabetes mellitus | 0.84 (0.52–1.19) | 0.390 | 0.96 (0.67–1.38) | 0.839 | |
Previous stroke | 1.11 (0.87–1.38) | 0.380 | 1.40 (0.55–3.23) | 0.560 | |
Previous bleeding | 2.07 (0.72–5.71) | 0.184 | 1.28 (0.85–1.91) | 0.215 | |
Coronary stent | 0.76 (0.54–1.09) | 0.119 | 0.70 (0.42–1.17) | 0.148 | |
OAC | 0.32 (0.18–0.57) | < 0.001* | 0.47 (0.28–0.77) | 0.009* | |
APT | 0.71 (0.54–0.95) | 0.015* | 0.57 (0.42–0.75) | < 0.001* |