SAFETY AND EFFICACY OF ANTITHROMBOTIC TREATMENT AFTER CAROTID STENTING IN PATIENTS WITH CONCOMITANT AURICULAR FIBRILATION (ID 1231)
- Blanca Pardo-Galiana (Spain)
- Manuel Medina-Rodríguez (Spain)
- Manuel Millan-Vazquez (Spain)
- Juan Antonio Cabezas Rodríguez (Spain)
- Lucía Lebrato-Hernandez (Spain)
- Leire Ainz Gomez (Spain)
- Irene Escudero-Martinez (Spain)
- Elena Zapata-Arriaza (Spain)
- Joaquin Ortega-Quintanilla (Spain)
- Asier De Albóniga-Chindurza (Spain)
- Alejandro Gonzalez Garcia (Spain)
- Francisco Moniche (Spain)
Abstract
Background And Aims
Triple antithrombotic therapy (TT) with oral anticoagulant and dual antiplatelet therapy (DAPT) in patients undergoing carotid stenting (CAS) with concomitant atrial fibrillation (AF) confers an elevated bleeding risk. The combination of clopidogrel and direct oral anticoagulant (DOAC) decreases major bleedings compared to TT with similar thrombotic events in the setting of myocardial infarction and AF, but it is not known in CAS patients.
Methods
A retrospective observational single-center study including patients with AF undergoing CAS was performed. Three groups were analyzed according to antithrombotic therapy within first month after CAS: Group 1 (DOAC plus clopidogrel), Group 2 (TT) and Group 3 (DAPT). Baseline characteristics, CHADs2-VAsC and HAS-BLED scores were recorded. Primary outcome was defined as major bleeding at 30 days and secondary outcome as ischemic events at 30 days.
Results
Ninety-one patients were analyzed (Group 1=24, Group 2=42, Group 3=25), 82.4% men and mean age of 72,8±16,2 years. Baseline characteristics were similar within groups. Median CHA2DS-VASc score was 6[5-6], 5[4-6] and 5[4-6], p=0.55, respectively, and the median HAS-BLED score was 4 in the three groups (p=0.17). Eleven patients had a bleeding event at 30 days, considering ten as major bleedings (group 1=0% vs group 2=23,8% vs group 3=4%, p=0,006). One stroke was observed in groups 1 and 3 (p=0,42).
Conclusions
In our study, the administration of DOAC plus clopidogrel during the first month after CAS in patients with concomitant AF was associated with significant lower rates of bleeding and no differences in thrombotic events. Prospective studies are warranted.
Trial Registration Number
Not applicable
