Comparison of different antithrombotic therapies in patients with atrial fibrillation coronary artery disease after percutaneous coronary intervention

Objective Comparison of different strategies in patients with atrial fibrillation (AF) complicated coronary heart disease (CHD) undergoing percutaneous coronary intervention (PCI). Methods A total of 90 AF+CAD patients undergoing PCI were divided into trigeminy antithrombotic therapy group (TT group, n=30), bigeminy antithrombotic therapy group[DT group, n=30] and warfarin and clopidogrel group (WS group, n=30) based on the antithrombotic therapies after discharge; Other secondary preventions were the same in these groups. These patients were followed up around 12 months for clinical outcome events the data of which were recorded and analyzed. Results The overall patients had higher risk of stroke (CHA2DS2-VASc score ≥ 2, 58%) and a slightly lower risk of bleeding(HAS-BLED score ≥ 3, 49%), but there was no significant statistical difference (P>0.05). Patients with triple antithrombotic therapy had a significant reduction in stroke and major adverse cardiac and cerebral events (MACCE, 6.7%, χ²=6.193, P=0.045). Bonferroni pairwise comparison indicated that TT and DT groups showed statistical significance(χ²=5.454, P=0.021) while the other two groups had no significant difference(P>0.05). The results showed that there was a difference between TT group and DT group (χ²=5.454, P=0.021) by Bonferroni method, but there was no statistical difference between the other two groups (P>0.05).The incidences of major bleeding among three groups had no statistical significance (χ²=0.000, P=1.000). The TT group had a high rate of secondary bleeding(13.3%) but the three groups had no significant difference (χ²=1.098, P=0.577). Conclusion For patients with atrial fibrillation complicated with coronary heart disease after PCI, the rate of ischemic stroke and MACCE in TT group was better than that in other group, and there was no difference between WS group and DT group.