Postpartum Antithrombotic Duration in Pregnant Women With Atrial Fibrillation
Document Type
Conference Proceeding
Publication Date
4-2025
Publication Title
Heart Rhythm
Abstract
Background: The use of antithrombotics in pregnant women with atrial fibrillation (AF) requires careful consideration. However, studies evaluating the impact of the duration of antithrombotic use during the postpartum period are limited. Objective: We aimed to assess the clinical outcomes associated with different durations of postpartum antithrombotic therapy in pregnancies with AF. Methods: TriNetX network was utilized to identify pregnant women with AF admitted for delivery (2014 to 2023). Patients were categorized based on the duration of postpartum antithrombotics used- ,3 months or .3 months groups. Primary outcomes were all-cause mortality, major bleeding, ischemic stroke, ischemic heart disease, and all-cause hospitalization. Subanalyses were conducted for 3-year (patients from 2014-2021) and 5-year follow-up periods (patients from 2014-2019) to evaluate the same outcomes. Results: After propensity score matching, there were 556 pregnant women with AF (278 in each cohort receiving postpartum antithrombotics for ,3 months or .3 months). Those who had postpartum antithrombotics for ,3 months were associated with significantly lower odds of major bleeding at 1 year (aOR 0.52, 95% CI 0.29–0.91, p50.02), 3 years (aOR 0.38, 95% CI 0.23–0.62, p,0.01), and 5 years (aOR 0.38, 95% CI 0.23–0.62, p,0.01). Similarly, it was also associated with reduced all-cause hospitalization at 1 year (aOR 0.65, 95% CI 0.47–0.91, p50.01), 3 years (aOR 0.56, 95% CI 0.39–0.79, p,0.01), and 5 years (aOR 0.57, 95% CI 0.40–0.81, p,0.01). No significant differences were observed between the groups in all-cause mortality, ischemic stroke, or ischemic heart disease at 1-, 3-, and 5-year follow-ups. Conclusion: Postpartum antithrombotic therapy for ,3 months in postpartum with AF was associated with lower odds of major bleeding and all-cause hospitalization, with no differences in all-cause mortality, ischemic stroke, or ischemic heart disease compared to therapy lasting .3 months.
Volume
22
Issue
4 Suppl
First Page
S237
Last Page
S237
Recommended Citation
Yeo YH, Vignarajah A, Ong TE, Vigneswaramoorthy N, Mehta N. Postpartum antithrombotic duration in pregnant women with atrial fibrillation. Heart Rhythm. 2025 Apr;22(4 Suppl):S237. doi: 10.1016/j.hrthm.2025.03.498
DOI
10.1016/j.hrthm.2025.03.498
Comments
Heart Rhythm Society Annual Meeting, April 24-27, 2025, San Diego, CA