Archives of Cardiovascular Diseases Supplements | 2019
Should antithrombotic therapy be different in patients with atrial fibrillation and a so-called temporary cause and especially after an acute coronary syndrome?
Abstract
Background Atrial fibrillation (AF) may be related to acute, temporary causes such as alcohol use, myocardial ischemia, myocarditis, hyperthyroidism, etc. It remains unclear whether antithrombotic management should be different in this setting after resolution of the episode. Purpose Our objective was to describe the outcomes in patients with such a temporary cause of AF (TCAF), and to compare the specific subgroup of patients with TCAF associated with acute coronary syndrome (ACS) to other patients with TCAF with regard to antithrombotic management. Methods All patients with AF seen in our institution between 2000 and 2010 were identified in a database. The adverse outcomes were investigated during follow-up. Results Among 8962 patients with AF, 5467 patients with non-permanent AF of whom 920 (17%) had at least one possible temporary cause of AF. TCAF patients had higher CHA2DS2VASc score than other patients (3.6\xa0±\xa01.7 versus 3.0\xa0±\xa01.7, P\xa0 Conclusion In patients with a possibly TCAF, use of oral anticoagulation was independently associated with a better prognosis. Antiplatelet therapy use was also independently associated with a better prognosis when patients with TCAF had ACS.