Why the study?
To evaluate the efficacy and safety of antithrombotic therapy with rivaroxaban and clopidogrel in Chinese patients with acute coronary syndrome complicated by atrial fibrillation after percutaneous coronary intervention.
Does dual therapy with rivaroxaban and clopidogrel reduce adverse cardiac and cerebrovascular events in Chinese patients with acute coronary syndrome complicated with atrial fibrillation after percutaneous coronary intervention?
Does dual therapy with rivaroxaban and clopidogrel reduce adverse cardiac and cerebrovascular events in Chinese patients with acute coronary syndrome complicated with atrial fibrillation after percutaneous coronary intervention?
In Chinese patients with ACS and AFib undergoing PCI, dual therapy with rivaroxaban and clopidogrel showed similar efficacy but significantly lower bleeding risk compared to traditional triple therapy with warfarin, aspirin, and clopidogrel.
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Supports rivaroxaban-clopidogrel dual therapy to reduce bleeding with comparable efficacy in Chinese ACS-AF patients post-PCI; extends randomized evidence to this population.
OBJECTIVE: To investigate the efficacy and safety of the antithrombotic therapy using the oral anticoagulant rivaroxaban and clopidogrel in Chinese patients with acute coronary syndrome complicated with atrial fibrillation after percutaneous coronary intervention. METHODS: A total of 100 patients were selected. Patients were randomly divided into two groups: the treatment group (rivaroxaban group) received a therapy of rivaroxaban and clopidogrel. The control group (warfarin group) receivied a combined treatment of warfarin, clopidogrel, and aspirin. The primary outcome endpoint was evaluated based on the adverse cardiac and cerebrovascular events within 12 months. RESULTS: A total of 8 (8.00%) main adverse cardiac and cerebrovascular events occurred during the 12 months of follow-up, including 5 (9.80%) in the warfarin group and 3 (6.10%) in the rivaroxaban group. The risk of having main adverse cardiac and cerebrovascular events in the two groups was comparable (P = 0.479). A total of 9 patients (9.00%) were found to have bleeding events, among which 8 patients (15.7%) were in the warfarin group, whereas only 1 patient (2.00%) was in the rivaroxaban group. Therefore, the risk of bleeding in the warfarin group was significantly higher than that in the rivaroxaban group (P = 0.047). CONCLUSIONS: In Chinese patients with acute coronary syndrome complicated with atrial fibrillation, the efficacy of the dual therapy of oral anticoagulant rivaroxaban plus clopidogrel after percutaneous coronary intervention was similar to that of the traditional triple therapy combined with warfarin, aspirin and clopidogrel, but it has a better safety property, which has potential to widely apply to antithrombotic therapy after PCI.
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Bai et al. (2022) studied this question.
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