Moznosti magneticke rezonance pri sledovani zmen u Morbus Legg-Calve-Perthes

Available from STL Prague, CZ / NTK - National Technical LibrarySIGLECZCzech Republi

Antithrombotic therapy of patients with atrial fibrillation discharged after major non-cardiac surgery. 1-year follow-up. Sub-analysis of PRAGUE 14 study

<div><p>Background</p><p>The study investigated the discharge antithrombotic medication in patients with atrial fibrillation (AF) after major non-cardiac surgery and the impact on one-year outcomes.</p><p>Methods</p><p>A subgroup of 366 patients (mean age 75.9±10.5 years, women 42.3%, acute surgery 42.9%) undergoing major non-cardiac surgery and having any form of AF (30.6% of the total population enrolled in the PRAGUE-14 study) was followed for 1 year.</p><p>Results</p><p>Antithrombotics (interrupted due to surgery) were resumed until discharge in 51.8% of patients; less frequently in men (OR 0.6 (95% CI 0.95 to 0.35); p = 0.029), and in patients undergoing elective surgery (OR 0.6 (95% CI 0.91 to 0.33); p = 0.021). Dual antiplatelet therapy was resumed more often (91.7%) in comparison to aspirin monotherapy (57.3%; p = 0.047), and vitamin K antagonist (56.3%; p = 0.042). Patients with AF had significantly higher one-year mortality (22.1%) than patients without AF (14.1%, p = 0.001). The causes of death were: ischaemic events (32.6% of deaths), bleeding events (8.1%), others (N = 51; 59.3%, 20 of them died due to cancer). Non-reinstitution of aspirin until discharge was associated with higher one-year mortality (17.6% vs. 34.8%; p = 0.018).</p><p>Conclusion</p><p>Preoperatively interrupted antithrombotics were re-administrated at discharge only in half of patients with AF, less likely in male patients and those undergoing elective surgery. The presence of AF was recognized as a predictor of one-year mortality, especially if aspirin therapy was not resumed until discharge.</p><p>Trial registration</p><p>ClinicalTrials.gov <a href="https://clinicaltrials.gov/ct2/show/NCT01897220" target="_blank">NCT01897220</a></p></div

Baseline characteristics of PRAGUE 14 study population according to presence of AF.

<p>Baseline characteristics of PRAGUE 14 study population according to presence of AF.</p

One-year survival of patients with AF after non-cardiac surgery.

<p>One-year survival of patients with AF after non-cardiac surgery.</p

Baseline characteristics of patients with AF according to preoperative usage of aspirin vs VKA.

<p>Baseline characteristics of patients with AF according to preoperative usage of aspirin vs VKA.</p

Re-administration of antithrombotic drugs according to surgery departments.

<p>Re-administration of antithrombotic drugs according to surgery departments.</p

Baseline characteristics of patients with AF according to (not) re-administration of aspirin and VKA until hospital discharge.

<p>Baseline characteristics of patients with AF according to (not) re-administration of aspirin and VKA until hospital discharge.</p

One-year survival of patients on aspirin after non-cardiac surgery.

<p>One-year survival of patients on aspirin after non-cardiac surgery.</p

Antithrombotic treatment re-administration in the period of up to 1 year after discharge.

<p>Antithrombotic treatment re-administration in the period of up to 1 year after discharge.</p