Characteristics and outcomes in patients with atrial fibrillation and acute coronary syndrome treated with ticagrelor and novel oral anticoagulants

• Published in: Thrombosis update 2021-05, Vol.3, p.100054, Article 100054
• Main Authors: van der Pals, Jesper, Holmqvist, Fredrik, Borgquist, Rasmus, Götberg, Matthias, Nseir, Mohaned, Koul, Sasha, Isma, Nazim, Scherstén, Fredrik, Tydén, Patrik, Braun, Oscar Ö., Erlinge, David
• Format: Article
• Language: English
• Subjects: Acute coronary syndrome; Antithrombotic therapy; Novel oral anticoagulants; Ticagrelor
• ISSN: 2666-5727; 2666-5727
• DOI: 10.1016/j.tru.2021.100054

Optimal antithrombotic treatment after an acute coronary syndrome (ACS) in patients with atrial fibrillation is unclear. Data on outcomes in patients on concomitant ticagrelor and the novel oral anticoagulants (NOAC) is scarce. This study therefore sought to describe patient characteristics and treatment outcomes in patients with atrial fibrillation and ACS treated with concomitant ticagrelor and NOACs (double antithrombotic therapy, DT). We retrospectively identified all ACS patients with atrial fibrillation on DT upon discharge from Skåne University Hospital in Lund, Sweden, between 2016 and 2019. Identified patients were compared with age and sex matched controls with ACS alone treated with ticagrelor and aspirin (DAPT). Major bleeding was defined in accordance with the HAS-BLED derivation study. Patients were retrospectively followed for six months. In total, 341 patients on DT were identified and compared with 341 controls on DAPT. Mean HAS-BLED bleeding risk score was higher in patients on DT (2.9 ± 1.0 vs 2.6+/0.9 units, p