%0 Journal Article
%T Real world risk of discontinuing oral anticoagulation after successful catheter ablation for atrial fibrillation.
%A Fei ZT
%A Yao PC
%A Chen M
%A Fei YD
%A Li W
%A Zhang PP
%A Sun J
%A Wang QS
%A Li YG
%J Heliyon
%V 10
%N 12
%D 2024 Jun 30
%M 38994101
%F 3.776
%R 10.1016/j.heliyon.2024.e32516
%X <B>UNASSIGNED: </B>Many patients with atrial fibrillation (AF) discontinued oral anticoagulation (OAC) therapy after successful catheter ablation. We aimed to determine the real-world risks and consequences of discontinuing OAC use after catheter ablation for AF.<BR><B>UNASSIGNED: </B>Patients who underwent successful catheter ablation for AF from January 2004 to December 2020 were divided into continued long-term OAC (On-OAC, n = 1062) and discontinued (Off-OAC, n = 1055) groups. The long-term outcomes including thromboembolic events, major bleeding, all-cause mortality and major adverse cardiovascular events (MACE), were compared between the two groups.<BR><B>UNASSIGNED: </B>The CHA2DS2-VASc score was 3.44 ± 1.12. After a mean follow-up of 37.09 months, thromboembolism risk was higher and major bleeding risk was lower in the Off-OAC than in the On-OAC group (Both log-rank P < 0.001). CHA2DS2-VASc score-stratified subgroup analysis showed similar cumulative event rates between the two groups in men and women with scores of 2 and 3 (intermediate risk for stroke), respectively, (P > 0.05), except for a higher major bleeding rate in the On-OAC group (P = 0.002). Patients at high risk for stroke (men and women with scores ≥3 and ≥ 4) had better non-thromboembolic and non-MACE results (Both log-rank P < 0.05).<BR><B>UNASSIGNED: </B>Men with a CHA2DS2-VASc score of 2 and women with a score of 3 had a relatively low incidence of stroke events after successful catheter ablation for AF and may be safe for anticoagulation cessation. Greater benefits from long-term OAC were observed in men with CHA2DS2-VASc score ≥3 and women with score ≥4.