{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T22:05:07Z","timestamp":1761948307418,"version":"3.41.2"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2017,8,2]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Patients receiving oral anticoagulation in addition to dual\u2010antiplatelet therapy are known to be at high risk for bleeding events; thus, the selection of a drug\u2010eluting stent (DES) versus a bare metal stent (BMS) can have important implications for patients with atrial fibrillation (AF) presenting with acute myocardial infarction (MI).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              From the National Cardiovascular Data Registry ACTION (Acute Coronary Treatment and Intervention Outcomes Network) Registry\u2014Get With the Guidelines, we identified 14\u00a0427 AF patients presenting with acute MI undergoing percutaneous coronary intervention from 2008 to 2014. Temporal trends and hospital variation in DES use were examined, as were patterns of use by stroke risk (CHA\n              <jats:sub>2<\/jats:sub>\n              DS\n              <jats:sub>2<\/jats:sub>\n              \u2010VASc) and bleeding risk ATRIA (Anticoagulation and Risk Factors in Atrial Fibrillation). Among patients with linked Medicare data (n=2844), multivariable Cox regression modeling was used to compare risks for a composite outcome (all\u2010cause mortality, readmission for stroke, or MI), readmission for stroke, revascularization, and major bleeding at 1\u00a0year. A DES was used in 8414 (58.9%) MI patients with AF, increasing from 47.1% in 2008 to 67.9% in 2014, with wide variation among hospitals. DES placement was more common than BMS placement among patients at high stroke risk (CHA\n              <jats:sub>2<\/jats:sub>\n              DS\n              <jats:sub>2<\/jats:sub>\n              \u2010VASc \u22652) and high bleeding risk (ATRIA \u22654). Although aspirin and a P2Y\n              <jats:sub>12<\/jats:sub>\n              inhibitor were prescribed for &gt;95% of all patients regardless of stent type at discharge, warfarin was prescribed less frequently among patients receiving a DES than a BMS (31% versus 39%,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). The composite outcome was similar between patients with a DES or BMS at 1\u00a0year (22% versus 26%; adjusted hazard ratio: 0.88; 95% confidence interval [CI], 0.76\u20131.03).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Use of DESs among MI patients with AF has increased over time, but substantial hospital\u2010level variation was observed. Patients with AF meeting indications for anticoagulation are more likely to receive a DES than a BMS, even among those at high predicted risk of both stroke and bleeding.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.116.005280","type":"journal-article","created":{"date-parts":[[2017,9,1]],"date-time":"2017-09-01T18:25:38Z","timestamp":1504290338000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Selection of Stent Type in Patients With Atrial Fibrillation Presenting With Acute Myocardial Infarction: An Analysis From the ACTION (Acute Coronary Treatment and Intervention Outcomes Network) Registry\u2014Get With the Guidelines"],"prefix":"10.1161","volume":"6","author":[{"given":"Amit N.","family":"Vora","sequence":"first","affiliation":[{"name":"Duke Clinical Research Institute, Duke University Medical Center, Durham, NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tracy Y.","family":"Wang","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Duke University Medical Center, Durham, NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuang","family":"Li","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Duke University Medical Center, Durham, NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Chiswell","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Duke University Medical Center, Durham, NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Connie","family":"Hess","sequence":"additional","affiliation":[{"name":"University of Colorado School of Medicine, Aurora, CO"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renato D.","family":"Lopes","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Duke University Medical Center, Durham, NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sunil V.","family":"Rao","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Duke University Medical Center, Durham, NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric D.","family":"Peterson","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Duke University Medical Center, Durham, NC"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2015.05.026"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.11.053"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1607991"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.03.513"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.112.097014"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2014.04.035"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.11.019"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.111.965186"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.03.022"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euq350"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehu298"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehw210"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2010.200261"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.108.847145"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.07.020"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2009.04.002"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.2307\/2531248"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.1214\/aos\/1176350951"},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2010.10.004"},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.1097\/MCA.0000000000000376"},{"key":"e_1_3_5_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.09.017"},{"key":"e_1_3_5_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.11.008"},{"key":"e_1_3_5_24_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehu523"},{"key":"e_1_3_5_25_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehv511"},{"key":"e_1_3_5_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2013.06.015"},{"key":"e_1_3_5_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)60263-X"},{"key":"e_1_3_5_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.05.029"},{"key":"e_1_3_5_29_2","unstructured":"Study apixaban to vitamin K antagonist for the prevention of stroke or systemic embolism and bleeding in patients with non\u2010valvular atrial fibrillation and acute coronary syndrome\/percutaneous coronary intervention. 2015. Available at: http:\/\/clinicaltrials.gov. Accessed March 29 2017."},{"key":"e_1_3_5_30_2","unstructured":"Evaluation of dual therapy with dabigatran vs. triple therapy with warfarin in patients with AF that undergo a PCI with stenting (REDUAL\u2010PCI). 2015."},{"key":"e_1_3_5_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2014.12.006"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.116.005280","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T10:53:17Z","timestamp":1715597597000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.116.005280"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,8,2]]},"references-count":30,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2017,8,2]]}},"alternative-id":["10.1161\/JAHA.116.005280"],"URL":"https:\/\/doi.org\/10.1161\/jaha.116.005280","relation":{},"ISSN":["2047-9980"],"issn-type":[{"type":"electronic","value":"2047-9980"}],"subject":[],"published":{"date-parts":[[2017,8,2]]},"assertion":[{"value":"2017-03-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-05-26","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-08-21","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e005280"}}