Authors
Recep Polat, Fuat Polat, Yalçın Velibey, Osman Bolca, Göktürk İpek
Published in
Cardiovascular therapeutics. Volume 2026. Issue 1. Pages e1295386.
Abstract
Managing STEMI and high-risk NSTEMI-equivalent patients on chronic oral anticoagulation (OAC) undergoing primary PCI poses competing ischaemic and bleeding risks.
This single-centre retrospective study enrolled 604 consecutive STEMI/high-risk NSTEMI patients undergoing primary PCI (2012-2023). OAC users (n = 100) were compared with propensity score-matched controls (n = 203). Primary endpoints included all-cause mortality, bleeding, stroke, recurrent MI and rehospitalisation over a mean 3-year follow-up.
OAC users had a higher prevalence of prior ischaemic stroke/TIA (19% vs. 3%, p < 0.001) and known coronary artery disease (33% vs. 20%, p = 0.015). In-hospital mortality was comparable (7% vs. 5.9%, p = 0.80). Postdischarge long-term mortality was significantly higher in OAC users (31% vs. 14.8%, p = 0.001), as were access-site haematoma (8% vs. 2%, p = 0.02) and minor bleeding (7% vs. 1.5%, p = 0.03). On multivariable Cox regression, OAC use was not an independent mortality predictor (HR 0.81, 95% CI 0.47-1.37, p = 0.43); age, reduced ejection fraction and chronic kidney disease were the principal determinants.
Despite higher postdischarge mortality and bleeding, OAC use was not independently associated with mortality after adjustment. Comorbidity burden drives prognosis, emphasising comprehensive risk stratification in this population.
PMID:
42817583
Bibliographic data and abstract were imported from PubMed on 01 Oct 2026.
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