A study of the efficacy and safety of antithrombotic therapy in aging patients with atrial fibrillation and coronary disease / 重庆医学

ABSTRACT

Objective To investigate the efficacy and safety of different strategy of antithrombotic therapy in elderly patients with atrial fibrillation (AF) and coronary disease.Methods 224 inpatients and outpatients with AF and coronary disease whose mean follow-up time was 2 years,were divided into warfarin group,warfarin combined with antiplatelet drug(aspirin or clopidogrel) group,antiplatelet drug(aspirin or clopidogrel) group and control group.The thromboembolic event rate and adverse events incidence were observed in different groups.Results The risk of thromboembolic events,particular emerging risk of cerebral infarction in the control group(12.50 ％) was significantly higher than other groups (P＜ 0.05).Thrombotic event rates in warfarin + single joint group(2.78％) was lower than other groups(warfarin group 4.29 ％,single joint group 5.81％),but there was no significant statistical difference.The overall risk of bleeding in the control group (3.13 ％) was significantly lower than other antithrombotic group (P＜0.05).The incidence of skin bruising in single joint group was lower than other antithrombotic groups,the overall bleeding risk,especially gasfrointestinal bleeding in warfarin+ single joint group was significantly higher than other groups (P＜ 0.05).Conclusion Elderly patients with coronary heart disease and atrial fibrillation need antithrombotic therapy to prevent thrombotic events.Using warfarin alone or warfarin combined antiplatelet drug does not lead to serious bleeding events,but generally bleeding risk should be attracted more attention.