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Research Article
Clinical Utility of the BIWACO Score for Patients With Atrial Fibrillation After Percutaneous Coronary Intervention
Atsuyuki Wada
Kusatsu General Hospital Cardiovascular Disease and Heart Failure Center, 1660 Yabase, Kusatsu, Shiga, Japan
Corresponding Author
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Background: No predictive clinical risk scores for net adverse clinical events (NACE) have been developed in patients with atrial fibrillation (AF) after percutaneous coronary intervention (PCI).
Methods: We evaluated the NACE in order to develop clinically applicable risk-stratification scores in the BIWACO study, a multicenter survey which enrolled a total of 7837 patients. We also investigated the current status and time trends for the use of antithrombotic drugs.
Results: A total of 188 AF patients who had received PCI were enrolled. At discharge, 65% of patients were prescribed a triple therapy (TT), 6% were prescribed a dual therapy, the remaining 29% of patients received dual-antiplatelet therapy. Over 3 years, the fraction of patients continuing TT decreased by 15%, whereas only 2% received oral anticoagulant alone. NACE developed in 20% of patients, resulting in the deaths of 5% patients, and 13% experiencing bleeding events. We developed risk scores for NACE comprising the five best predictive items, which we designated BIWACO scores. The area under the curve was 0.774 for NACE.
Conclusions: Our study explored the differences in treatment practices and guideline recommendations for antithrombotic therapy. We concluded that our BIWACO score is useful for predicting clinical outcomes in AF-patients after PCI.
Keywords
anticoagulants, atrial fibrillation, percutaneous coronary intervention, risk score
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This preprint is under consideration at Scientific Reports. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
Clinical Utility of the BIWACO Score for Patients With Atrial Fibrillation After Percutaneous Coronary Intervention
Atsuyuki Wada
Kusatsu General Hospital Cardiovascular Disease and Heart Failure Center, 1660 Yabase, Kusatsu, Shiga, Japan
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 12 Jan, 2021
No community comments so far
Editor invited
On 08 Jan, 2021
Submission checks complete
On 08 Jan, 2021
First submitted
On 15 Dec, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Cardiac & Cardiovascular Systems
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: No predictive clinical risk scores for net adverse clinical events (NACE) have been developed in patients with atrial fibrillation (AF) after percutaneous coronary intervention (PCI).
Methods: We evaluated the NACE in order to develop clinically applicable risk-stratification scores in the BIWACO study, a multicenter survey which enrolled a total of 7837 patients. We also investigated the current status and time trends for the use of antithrombotic drugs.
Results: A total of 188 AF patients who had received PCI were enrolled. At discharge, 65% of patients were prescribed a triple therapy (TT), 6% were prescribed a dual therapy, the remaining 29% of patients received dual-antiplatelet therapy. Over 3 years, the fraction of patients continuing TT decreased by 15%, whereas only 2% received oral anticoagulant alone. NACE developed in 20% of patients, resulting in the deaths of 5% patients, and 13% experiencing bleeding events. We developed risk scores for NACE comprising the five best predictive items, which we designated BIWACO scores. The area under the curve was 0.774 for NACE.
Conclusions: Our study explored the differences in treatment practices and guideline recommendations for antithrombotic therapy. We concluded that our BIWACO score is useful for predicting clinical outcomes in AF-patients after PCI.
Figure 1
Figure 2
Figure 3
Figure 4
Figure 5