PDF(Pubmed)
Abstract：
UNASSIGNED: Dual antithrombotic therapy (DAT) combining oral anticoagulation (OAC), preferentially Non-vitamin K antagonist OAC (NOAC) and single antiplatelet therapy (SAPT) for a period of 6-12 months is recommended after percutaneous coronary intervention (PCI) in patients with an indication for OAC.
UNASSIGNED: To compare outcomes between vitamin K antagonist (VKA) and NOAC-treated patients in the nation-wide France PCI registry.
UNASSIGNED: All consecutive patients from the France PCI registry treated by PCI and discharged with OAC between 2014 and 2020 were included and followed one-year. Major bleeding was defined as Bleeding Academic Research Consortium (BARC) classification ≥3 and major adverse cardiac events (MACE) as the composite of all-cause mortality, myocardial infarction (MI), and ischemic stroke. A propensity-score analysis was used.
UNASSIGNED: Of the 7,277 eligible participants, 2,432 (33.4%) were discharged on VKA and 4,845 (66.6%) on NOAC. After propensity-score adjustment, one-year major bleeding was less frequent in NOAC vs. VKA-treated participants [3.1% vs. 5.2%, -2.1% (-3.6% to -0.6%), p = 0.005 as well as the rate of MACE [9.2% vs. 11.9%, -2.7% (-5.0% to -0.4%), p = 0.02]. One-year mortality was also significantly decreased in NOAC vs. VKA-treated participants [7.4% vs. 9.9%, -2.6% (-4.7% to -0.5%), p = 0.02]. The area under ROC curves of the anticoagulant treatment propensity score was estimated at 0.93, suggesting potential indication bias.
UNASSIGNED: NOAC seems to have a better efficacy and safety profile than VKA. However, potential indication bias were found.
UNASSIGNED: To compare outcomes between vitamin K antagonist (VKA) and NOAC-treated patients in the nation-wide France PCI registry.
UNASSIGNED: All consecutive patients from the France PCI registry treated by PCI and discharged with OAC between 2014 and 2020 were included and followed one-year. Major bleeding was defined as Bleeding Academic Research Consortium (BARC) classification ≥3 and major adverse cardiac events (MACE) as the composite of all-cause mortality, myocardial infarction (MI), and ischemic stroke. A propensity-score analysis was used.
UNASSIGNED: Of the 7,277 eligible participants, 2,432 (33.4%) were discharged on VKA and 4,845 (66.6%) on NOAC. After propensity-score adjustment, one-year major bleeding was less frequent in NOAC vs. VKA-treated participants [3.1% vs. 5.2%, -2.1% (-3.6% to -0.6%), p = 0.005 as well as the rate of MACE [9.2% vs. 11.9%, -2.7% (-5.0% to -0.4%), p = 0.02]. One-year mortality was also significantly decreased in NOAC vs. VKA-treated participants [7.4% vs. 9.9%, -2.6% (-4.7% to -0.5%), p = 0.02]. The area under ROC curves of the anticoagulant treatment propensity score was estimated at 0.93, suggesting potential indication bias.
UNASSIGNED: NOAC seems to have a better efficacy and safety profile than VKA. However, potential indication bias were found.
摘要：
■双重抗血栓治疗（DAT）联合口服抗凝（OAC），对于有OAC适应症的患者,建议在经皮冠状动脉介入治疗(PCI)后,优先使用非维生素K拮抗剂OAC(NOAC)和单一抗血小板治疗(SAPT),为期6~12个月.
■在法国全国PCI注册中比较维生素K拮抗剂（VKA）和NOAC治疗的患者之间的结果。
■在2014年至2020年期间接受PCI治疗并接受OAC出院的所有来自法国PCI注册的连续患者均被纳入并随访一年。大出血定义为出血学术研究联盟（BARC）分级≥3级，主要不良心脏事件（MACE）为全因死亡率的复合。心肌梗死（MI），和缺血性中风。使用倾向评分分析。
■在7,277名合格参与者中，在VKA上排放了2,432（33.4％），在NOAC上排放了4,845（66.6％）。在倾向得分调整后，NOAC与NOAC的一年大出血频率较低。VKA治疗的参与者[3.1%vs.5.2%,-2.1%（-3.6%至-0.6%），p=0.005以及MACE的比率[9.2%与11.9%,-2.7%（-5.0%至-0.4%），p=0.02]。NOAC的一年死亡率也显著下降。接受VKA治疗的参与者[7.4%vs.9.9%，-2.6%（-4.7%至-0.5%），p=0.02]。抗凝治疗倾向评分的ROC曲线下面积估计为0.93，提示潜在的指征偏倚。
■NOAC似乎比VKA具有更好的疗效和安全性。然而,发现了潜在的指征偏差。
■在法国全国PCI注册中比较维生素K拮抗剂（VKA）和NOAC治疗的患者之间的结果。
■在2014年至2020年期间接受PCI治疗并接受OAC出院的所有来自法国PCI注册的连续患者均被纳入并随访一年。大出血定义为出血学术研究联盟（BARC）分级≥3级，主要不良心脏事件（MACE）为全因死亡率的复合。心肌梗死（MI），和缺血性中风。使用倾向评分分析。
■在7,277名合格参与者中，在VKA上排放了2,432（33.4％），在NOAC上排放了4,845（66.6％）。在倾向得分调整后，NOAC与NOAC的一年大出血频率较低。VKA治疗的参与者[3.1%vs.5.2%,-2.1%（-3.6%至-0.6%），p=0.005以及MACE的比率[9.2%与11.9%,-2.7%（-5.0%至-0.4%），p=0.02]。NOAC的一年死亡率也显著下降。接受VKA治疗的参与者[7.4%vs.9.9%，-2.6%（-4.7%至-0.5%），p=0.02]。抗凝治疗倾向评分的ROC曲线下面积估计为0.93，提示潜在的指征偏倚。
■NOAC似乎比VKA具有更好的疗效和安全性。然而,发现了潜在的指征偏差。
