title: Bare-metal vs. drug-eluting stents in patients with atrial fibrillation undergoing percutaneous coronary intervention.
abstract: BACKGROUND
  We explored 12-month clinical outcomes of 929 patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI) with bare-metal stents (BMS) vs. drug-eluting stents (DES) from the prospective multicenter AFCAS (Atrial Fibrillation undergoing Coronary Artery Stenting) registry. METHODS AND RESULTS: Endpoints included the first occurrence of major adverse cardiac and cerebrovascular events (MACCE), defined as a composite of all-cause death, myocardial infarction (MI), target vessel revascularization, definite/probable stent thrombosis (ST), transient ischemic attack or stroke. Bleeding events were defined according to the Bleeding Academic Research Consortium criteria. Altogether, 673 (72.4%) patients received BMS and 220 (23.7%) at least one DES. Patients treated with DES more often had diabetes and prior ischemic events, and a longer stent length (P<0.05 for all), whereas patients treated with BMS more often had heart failure and were more likely to present with acute ST-elevation MI (P<0.05 for both). At 12-month follow-up, rates and risks of MACCE and total bleeding events were comparable between the groups (22.0% with BMS vs. 19.5% with DES, P=0.51, hazard ratio (HR) 0.89, 95% confidence interval (CI) 0.63-1.25 for DES) and (19.5% vs. 15.0%, respectively, P=0.16, HR 0.75, 95% CI 0.51-1.09 for DES). Definite/probable ST was more frequent in the BMS group (1.9% vs. 0%, respectively, P=0.046).
  
  
  CONCLUSIONS
  In real-world patients with AF undergoing PCI, DES use was associated with outcomes comparable to those with BMS without excess bleeding complications. More ST was seen in BMS-treated patients.
authors.affiliation: Heart Center, Turku University Hospital and University of Turku.
authors.forename: Tuomas
authors.initials: T
authors.lastname: Kiviniemi
authors.forename: Marja
authors.initials: M
authors.lastname: Puurunen
authors.forename: Axel
authors.initials: A
authors.lastname: Schlitt
authors.forename: Andrea
authors.initials: A
authors.lastname: Rubboli
authors.forename: Pasi
authors.initials: P
authors.lastname: Karjalainen
authors.forename: Wail
authors.initials: W
authors.lastname: Nammas
authors.forename: Paulus
authors.initials: P
authors.lastname: Kirchhof
authors.forename: Fausto
authors.initials: F
authors.lastname: Biancari
authors.forename: Gregory Yh
authors.initials: GY
authors.lastname: Lip
authors.forename: Ke Juhani
authors.initials: KJ
authors.lastname: Airaksinen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000401:mortality* / Q000628:therapy*; D018572:Disease-Free Survival; D054855:Drug-Eluting Stents; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D012042:Registries; D012307:Risk Factors; D015996:Survival Rate