Clinical outcomes in non-valvular atrial fibrillation with low CHA 2 DS 2 -VASc score after coronary stent implantation with and without hyperhomocysteinemia

Abstract

Objective: The aim is to demonstrate the clinical outcomes in non-valvular atrial fibrillation with low CHA 2 DS 2 -VASc score after coronary stent implantation with and without hyperhomocysteinemia. Methods: In a retrospective, multicenter, cohort study (2011–2013) in Beijing, China (n=1713), we compared non-valvular AF patients with CHA 2 DS 2 -VASc score =0 or 1 receiving dual antiplatelet therapy at discharge after coronary artery stent implantation and estimated absolute risks and relative risks (RRs) of major adverse cardiac events (MACE) within 1 year . They were divided into two groups according to the plasma HCY levels before catheterization: group normal (1135 patients, <15 μmol/L) and group hHcy (553 patients, ≥15 μmol/L). The primary endpoint, which was occurrence of major adverse cardiac events (MACE). Results: After 1year follow-up, the group hHcy patients had a higher MACE rate (p=0.017). The main differences between two groups were ischemic stroke (p=0.009), cardiac death (p=0.046) and non-fatal MI (p=0.044). Conclusions: Elevated Hcy level was independently associated with increased risk of MACE events in non-valvular atrial fibrillation patients with low CHA 2 DS 2 -VASc score after coronary artery stents implantations.