Temporal Trends in Antithrombotic Therapy for Patients With Atrial Fibrillation Undergoing Percutaneous Coronary Intervention From 2014 to 2022 in Japan
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- Nakano Yasuhiro
- Department of Cardiovascular Medicine, Kyushu University Hospital
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- Matoba Tetsuya
- Department of Cardiovascular Medicine, Kyushu University Hospital
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- Yamamoto Mitsutaka
- Department of Cardiovascular Medicine, Harasanshin Hospital
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- Katsuki Shunsuke
- Department of Cardiovascular Medicine, Kyushu University Hospital
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- Koga Yasuaki
- Department of Cardiovascular Medicine, Oita Prefectural Hospital
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- Mukai Yasushi
- Department of Cardiovascular Medicine, Japanese Red Cross Fukuoka Hospital
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- Inoue Shujiro
- Department of Cardiovascular Medicine, Aso Iizuka Hospital
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- Suematsu Nobuhiro
- Department of Cardiovascular Medicine, Saiseikai Fukuoka General Hospital
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- Higo Taiki
- Department of Cardiovascular Medicine, National Hospital Organization Kyushu Medical Centre
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- Takemoto Masao
- Cardiovascular Center, Steel Memorial Yawata Hospital
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- Miyata Kenji
- Department of Cardiovascular Medicine, Japan Community Health Care Organization, Kyushu Hospital
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- Usui Makoto
- Department of Cardiovascular Medicine, Hamanomachi Hospital
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- Kadokami Toshiaki
- Department of Cardiovascular Medicine, Saiseikai Futsukaichi Hospital
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- Tashiro Hideki
- Department of Cardiology, St. Mary’s Hospital
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- Morishige Kunio
- Department of Cardiovascular Medicine, Matsuyama Red Cross Hospital
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- Hironaga Kiyoshi
- Department of Cardiovascular Medicine, Fukuoka City Hospital
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- Tsutsui Hiroyuki
- Department of Cardiovascular Medicine, Kyushu University Hospital Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences
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Description
<p>Background: Recent revisions of clinical guidelines by the Japanese Circulation Society, American Heart Association/American College of Cardiology, and European Society of Cardiology updated the management of antithrombotic strategies for patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI). However, the extent to which these guidelines have been implemented in real-world daily clinical practice is unclear.</p><p>Methods and Results: We conducted surveys on the status of antithrombotic therapy for patients with AF undergoing PCI every 2 years from 2014 to 2022 in 14 cardiovascular centers in Japan. The primary use of drug-eluting stents increased from 10% in 2014 to 95–100% in 2018, and the use of direct oral anticoagulants increased from 15% in 2014 to 100% in 2018, in accordance with the revised practice guidelines. In patients with acute coronary syndrome, the duration of triple therapy within 1 month was approximately 10% until 2018, and increased to >70% from 2020. In patients with chronic coronary syndrome, the duration of triple therapy within 1 month was approximately 10% until 2016, and >75% from 2018. Since 2020, the most common timing of discontinuation of dual antiplatelet therapy to transition to anticoagulation monotherapy during the chronic phase of PCI has been 1 year after PCI.</p><p>Conclusions: Japanese interventional cardiologists have updated their treatment strategies for patients with AF undergoing PCI according to revisions of clinical practice guidelines.</p>
Journal
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- Circulation Reports
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Circulation Reports 5 (7), 282-288, 2023-07-10
The Japanese Circulation Society