Comparison of mid-term outcomes between patients with and without atrial fibrillation undergoing coronary stenting in the second-generation drug-eluting stent era: from the SHINANO registry.
Little is known about the mid-term outcomes of patients with atrial fibrillation (AF) who undergo coronary stenting in the second-generation drug-eluting stent (DES) era. We evaluated the 1-year outcomes of AF patients undergoing percutaneous coronary intervention (PCI) with second-generation DES. This retrospective cohort analysis used integrated data from the SHINANO registry, a prospective observational multicenter cohort study, which enrolled 1923 consecutive patients undergoing PCI for any coronary artery disease. We retrospectively recruited 917 of these patients (mean age, 71.3 ± 10.0 years; male, 77 %) who received PCI with 2nd generation DES. The primary endpoint was net adverse clinical events (NACE: cardiac death, stroke, MI, stent thrombosis, and major bleeding) at 1 year. The secondary endpoints were major adverse cardiovascular events (MACE: cardiac death, stroke, and MI), stroke, MI, and major bleeding at 1 year. One-year follow-up was completed in 871 (94.9 %) patients, of whom 85 had AF. The incidence of NACE (15.4 vs. 7.3 %, P = 0.008), MACE (10.6 vs. 5.4 %, P = 0.047), and major bleeding (6.0 vs. 2.3 %, P = 0.049) were all significantly higher in AF compared to non-AF patients. On multivariate analysis, AF was an independent predictor of NACE (HR 2.32, 95 % CI 1.24-4.34, P = 0.008). In the second-generation DES era, patients with AF undergoing PCI still have a poorer prognosis, with more thrombotic and bleeding events, than those without AF. More attention should be paid to the thrombotic and bleeding risk in AF patients undergoing PCI.
Department of Cardiovascular Medicine, Shinshu University School of Medicine, 1-1-3 Asahi, Matsumoto, 390-8621, Japan. miuramen10miuramen@yahoo.co.jp.
Takashi
T
Miura
Department of Cardiovascular Medicine, Shinshu University School of Medicine, 1-1-3 Asahi, Matsumoto, 390-8621, Japan.
Yusuke
Y
Miyashita
Department of Cardiovascular Medicine, Shinshu University School of Medicine, 1-1-3 Asahi, Matsumoto, 390-8621, Japan.
Hirohiko
H
Motoki
Department of Cardiology, Shinshu Ueda Medical Center, Ueda, Japan.
Hideki
H
Kobayashi
Department of Cardiology, Matsumoto Kyoritsu Hospital, Matsumoto, Japan.
Masanori
M
Kobayashi
Department of Cardiology, Nagano Matsushiro General Hospital, Nagano, Japan.
Hiroyuki
H
Nakajima
Department of Cardiology, Saku Central Hospital, Saku, Japan.
Hikaru
H
Kimura
Department of Cardiology, Iida Municipal Hospital, Iida, Japan.
Hiroshi
H
Akanuma
Department of Cardiology, Kita Alps Medical Center, Azumino, Japan.
Eiichiro
E
Mawatari
Department of Cardiology, Shinonoi General Hospital, Nagano, Japan.
Toshio
T
Sato
Department of Cardiology, Ina Central Hospital, Ina, Japan.
Shoji
S
Hotta
Department of Cardiology, Aizawa Hospital, Matsumoto, Japan.
Yuichi
Y
Kamiyoshi
Department of Cardiology, Shinonoi General Hospital, Nagano, Japan.
Takuya
T
Maruyama
Department of Cardiology, Hokushin General Hospital, Nakano, Japan.
Noboru
N
Watanabe
Department of Cardiology, Komoro Kosei General Hospital, Komoro, Japan.
Takayuki
T
Eizawa
Department of Cardiology, Aizawa Hospital, Matsumoto, Japan.
Shinichi
S
Aso
Department of Cardiology, Azumino Red Cross Hospital, Azumino, Japan.
Shinichiro
S
Uchikawa
Department of Cardiovascular Medicine, Shinshu University School of Medicine, 1-1-3 Asahi, Matsumoto, 390-8621, Japan.
Naoto
N
Hashizume
Department of Cardiology, Okaya Municipal Hospital, Okaya, Japan.
Keisuke
K
Senda
Department of Cardiology, Nagano Matsushiro General Hospital, Nagano, Japan.
Takehiro
T
Morita
Department of Cardiovascular Medicine, Shinshu University School of Medicine, 1-1-3 Asahi, Matsumoto, 390-8621, Japan.
Soichiro
S
Ebisawa
Department of Cardiovascular Medicine, Shinshu University School of Medicine, 1-1-3 Asahi, Matsumoto, 390-8621, Japan.
Atsushi
A
Izawa
Department of Cardiovascular Medicine, Shinshu University School of Medicine, 1-1-3 Asahi, Matsumoto, 390-8621, Japan.
Jun
J
Koyama
Department of Cardiovascular Medicine, Shinshu University School of Medicine, 1-1-3 Asahi, Matsumoto, 390-8621, Japan.
Uichi
U
Ikeda
D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D003327:Coronary Disease / Q000150:complications / Q000601:surgery*; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D008297:Male; D012042:Registries; D012189:Retrospective Studies; D016896:Treatment Outcome
Atrial fibrillation; Coronary artery disease; Percutaneous coronary intervention