Antithrombotic Therapy after Acute Coronary Syndrome or PCI in Atrial Fibrillation
Why the study?
Does an antithrombotic regimen including apixaban without aspirin reduce bleeding and hospitalizations in patients with atrial fibrillation and a recent acute coronary syndrome or PCI treated with a P2Y12 inhibitor?
Population
Patients with atrial fibrillation and a recent acute coronary syndrome or PCI treated with a P2Y12 inhibitor
Comparison
Apixaban without aspirin vs regimens including a vitamin K antagonist, aspirin, or both
Authors
Discussion
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Implication
Supports apixaban without aspirin to reduce bleeding and hospitalizations in AF with recent ACS/PCI; extends evidence for dual over triple antithrombotic therapy.
Key Points
- This research aims to compare the effectiveness and safety of different antithrombotic regimens in patients with atrial fibrillation after acute coronary syndrome or PCI.
- Patients with atrial fibrillation and recent acute coronary syndrome or PCI were enrolled.
- Antithrombotic regimens compared included apixaban without aspirin versus regimens with vitamin K antagonists or aspirin.
- The study registered under ClinicalTrials.gov number NCT02415400.
- The apixaban regimen resulted in fewer bleeding episodes compared to traditional regimens including aspirin or vitamin K antagonists.
- There was no significant difference in ischemic event rates between the apixaban group and the traditional regimens.
- Patients on the apixaban regimen experienced fewer hospitalizations.
Structured PICO
Does an antithrombotic regimen including apixaban without aspirin reduce bleeding and hospitalizations in patients with atrial fibrillation and a recent acute coronary syndrome or PCI treated with a P2Y12 inhibitor?
P
Population
Patients with atrial fibrillation and a recent acute coronary syndrome or PCI treated with a P2Y12 inhibitor
I
Intervention
Antithrombotic regimen that included apixaban, without aspirin
C
Comparator
Regimens that included a vitamin K antagonist, aspirin, or both
O
Outcome
Bleeding and hospitalizationssafety
In patients with atrial fibrillation and recent ACS or PCI, an apixaban-based regimen without aspirin reduces bleeding and hospitalizations compared to VKA and/or aspirin without increasing ischemic risk.
Cite This Study
Lópes et al. (2019) studied this question.