Impact of Underdosing of Direct Oral Anticoagulants on Clinical Outcomes in Patients With Atrial Fibrillation Undergoing Percutaneous Coronary Intervention

被引：3

作者：

Kitahara, Hideki ^{[1
]}

Yamazaki, Tatsuro ^{[1
]}

Hiraga, Takashi ^{[1
]}

Suzuki, Sakuramaru ^{[2
]}

Ohno, Yuji ^{[3
]}

Harada, Junya ^{[4
]}

Fukushima, Kenichi ^{[5
]}

Asano, Tatsuhiko ^{[6
]}

Ishio, Naoki ^{[7
]}

Uchiyama, Raita ^{[8
]}

Miyahara, Hirofumi ^{[9
]}

Okino, Shinichi ^{[10
]}

Sano, Masanori ^{[11
]}

Kuriyama, Nehiro ^{[12
]}

Yamamoto, Masashi ^{[13
]}

Sakamoto, Naoya ^{[14
]}

Kanda, Junji ^{[15
]}

Kobayashi, Yoshio ^{[1
]}

机构：

[1] Chiba Univ, Grad Sch Med, Dept Cardiovasc Med, 1-8-1 Inohana,Chuo Ku, Chiba, 2608677, Japan

[2] Eastern Chiba Med Ctr, Dept Cardiovasc Med, Chiba, Japan

[3] Narita Red Cross Hosp, Dept Cardiovasc Med, Chiba, Japan

[4] Chiba Cerebral & Cardiovasc Ctr, Div Cardiol, Chiba, Japan

[5] Matsudo City Gen Hosp, Dept Cardiol, Chiba, Japan

[6] Chiba Rosai Hosp, Dept Cardiol, Chiba, Japan

[7] Chiba Aoba Municipal Hosp, Dept Cardiol, Chiba, Japan

[8] Japan Community Healthcare Org Chiba Hosp, Dept Cardiovasc Med, Chiba, Japan

[9] Chiba Kaihin Municipal Hosp, Dept Cardiol, Chiba, Japan

[10] Funabashi Municipal Med Ctr, Dept Pathol, Chiba, Japan

[11] Chiba Emergency Med Ctr, Dept Cardiol, Chiba, Japan

[12] Miyazaki Med Assoc Hosp, Cardiovasc Ctr, Miyazaki, Japan

[13] Miyazaki Med Assoc Hosp, Cardiovasc Ctr, Miyazaki, Japan

[14] Chibaken Saiseikai Narashino Hosp, Div Cardiol, Chiba, Japan

[15] Asahi Gen Hosp, Dept Cardiovasc Med, Chiba, Japan

来源：

CIRCULATION JOURNAL | 2025年 / 89卷 / 02期

关键词：

Atrial fibrillation; Direct oral anticoagulants; Percutaneous coronary intervention; Underdosing; ANTITHROMBOTIC THERAPY; ANTIPLATELET THERAPY; WARFARIN; STROKE; LABEL;

D O I：

10.1253/circj.CJ-24-0418

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Methods and Results: This multicenter observational cohort study enrolled patients with AF on DOAC undergoing PCI between January 2015 and March 2021 at 15 institutions across Japan. Clinical outcomes within 1 year, including major adverse cardiovascular events (MACE), all-cause mortality, ischemic stroke, and major bleeding events, were evaluated. Of 623 patients enrolled, 167 (26.8%) received underdoses, 224 (36.0%) received appropriate low doses, 210 (33.7%) received appropriate standard doses, and 22 (3.5%) received overdoses. Clinical outcomes were compared between patients with underdoses (n=167) and appropriate doses (n=434). Although the incidence of MACE, all-cause mortality, and major bleeding events did not differ significantly between the 2 groups (log-rank P=0.850, P=0.163, and P=0.711, respectively), ischemic stroke occurred more frequently in the underdose than appropriate-dose group (log-rank P=0.011). After propensity score matching, the same result was observed for the frequency of

引用

页码：195 / 203

页数：9

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