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Elaborately Engineering a Self-Indicating Dual-Drug Nanoassembly for Site-Specific Photothermal-Potentiated Thrombus Penetration and Thrombolysis Comparison of 1-month Versus 12-month Dual Antiplatelet Therapy after Implantation of Drug-eluting Stents Guided by either Intravascular Ultrasound or Angiography in Patients with Acute Coronary Syndrome: Rationale and Design of Prospective, Multicenter, Randomized, Controlled IVUS-ACS & ULTIMATE-DAPT trial 2016 ACC/AHA guideline focused update on duration of dual antiplatelet therapy in patients with coronary artery disease: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines Dual Antiplatelet Therapy Duration in Medically Managed Acute Coronary Syndrome Patients: Sub-Analysis of the OPT-CAD Study Antibody-Based Ticagrelor Reversal Agent in Healthy Volunteers 6-month versus 12-month or longer dual antiplatelet therapy after percutaneous coronary intervention in patients with acute coronary syndrome (SMART-DATE): a randomised, open-label, non-inferiority trial Patient-oriented composite endpoints and net adverse clinical events with ticagrelor monotherapy following percutaneous coronary intervention: Insights from the randomized GLOBAL LEADERS trial Dual Antiplatelet TherapyIs It Time to Cut the Cord With Aspirin? Dual Antiplatelet Therapy Duration: Reconciling the Inconsistencies Prevention of Bleeding in Patients with Atrial Fibrillation Undergoing PCI
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Review Article2018 Nov;33(6):660-664.

JOURNAL：Curr Opin Cardiol. Article Link

New-onset atrial fibrillation after PCI and CABG for left main disease: insights from the EXCEL trial and additional studies

Kosmidou I, Stone GW. Keywords: nonsurgical atrial fibrillation; LMCAD; CABG; PCI; outcome

ABSTRACT

PURPOSE OF REVIEW - To provide an up-to-date review of recent trials examining the incidence and prognostic impact of new-onset atrial fibrillation (NOAF) following percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) for left main coronary artery disease (LMCAD) and the impact of postprocedural NOAF compared to nonsurgical atrial fibrillation.


RECENT FINDINGS - A recent analysis from the Evaluation of XIENCE versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization (EXCEL) trial demonstrated that NOAF is much more frequent following surgical compared with percutaneous revascularization for LMCAD, and is strongly associated with an increased 3-year risk of mortality and stroke. In a recent Danish registry-based, propensity score-matched analysis, postsurgical NOAF conferred a lower risk of adverse outcomes compared with nonsurgical nonvalvular atrial fibrillation.


SUMMARY - These new studies confirm that although postsurgical NOAF after left main revascularization may be of less clinical significance than nonvalvular atrial fibrillation, its occurrence still is strongly associated with subsequent stroke and mortality. Future efforts are warranted to prevent postsurgical NOAF and determine strategies for its optimal management should it occur.


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