{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T07:16:58Z","timestamp":1696317418234},"reference-count":31,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2013,12,11]],"date-time":"2013-12-11T00:00:00Z","timestamp":1386720000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2014,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Although atrial fibrillation (<jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content>) occurs frequently in patients hospitalized with acute coronary syndrome (<jats:styled-content style=\"fixed-case\">ACS<\/jats:styled-content>), strategies for prevention of thromboembolic complications are poorly characterized.<\/jats:p><\/jats:sec><jats:sec><jats:title>Hypothesis<\/jats:title><jats:p>We sought to examine exposure to warfarin and <jats:styled-content style=\"fixed-case\">P2Y12<\/jats:styled-content> inhibitors and clinical outcomes among patients with <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">ACS<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients age &gt;65\u2009years hospitalized with a primary diagnosis of <jats:styled-content style=\"fixed-case\">ACS<\/jats:styled-content> and a secondary diagnosis of <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content> between 2007 and 2010 were identified in the Medicare 5% sample. Medication exposure was ascertained during a 90\u2010day period following the index discharge using Medicare drug claims. Among patients who were alive and not readmitted during the ascertainment period, we examined the cumulative incidence of all\u2010cause mortality and all\u2010cause readmission by medication exposure at 1\u2009year.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 2509 Medicare beneficiaries met the inclusion criteria. Among the 1633 patients (65%) who were alive and not readmitted during the 90\u2010day ascertainment period, 24.0% received warfarin, 38.9% received <jats:styled-content style=\"fixed-case\">P2Y12<\/jats:styled-content> inhibitors, 10.2% received combination therapy, and 26.8% received neither therapy. Readmission rates were high in all groups at 1\u2009year (warfarin, 47.5%; <jats:styled-content style=\"fixed-case\">P2Y12<\/jats:styled-content> inhibitors, 46.6%; combination therapy, 38.0%; and neither therapy, 39.3%), and the overall 1\u2010year mortality rate was 12.5%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Among Medicare beneficiaries with <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">ACS<\/jats:styled-content>, combination therapy with warfarin and <jats:styled-content style=\"fixed-case\">P2Y12<\/jats:styled-content> inhibitor was uncommon during the 90\u2010day ascertainment period, and more than one\u2010quarter of patients had no claims for warfarin or <jats:styled-content style=\"fixed-case\">P2Y12<\/jats:styled-content> inhibitors. Rates of all\u2010cause readmission and mortality within 1\u2009year of hospitalization for <jats:styled-content style=\"fixed-case\">ACS<\/jats:styled-content> were high.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.22231","type":"journal-article","created":{"date-parts":[[2013,12,11]],"date-time":"2013-12-11T20:53:16Z","timestamp":1386795196000},"page":"152-159","source":"Crossref","is-referenced-by-count":1,"title":["Combined Use of Warfarin and Oral <scp>P2Y12<\/scp> Inhibitors in Patients With Atrial Fibrillation and Acute Coronary Syndrome"],"prefix":"10.1002","volume":"37","author":[{"given":"W. 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