Does low-dose or very-low-dose rivaroxaban reduce clinically significant bleeding compared to standard vitamin K antagonist therapy in participants with atrial fibrillation undergoing PCI with stent placement?
Participants with atrial fibrillation undergoing PCI with placement of stents
Low-dose rivaroxaban plus a P2Y12 inhibitor for 12 months OR very-low-dose rivaroxaban plus DAPT for 1, 6, or 12 months
Standard therapy with a vitamin K antagonist plus DAPT for 1, 6, or 12 months
Clinically significant bleedingsafety
In patients with atrial fibrillation undergoing PCI, rivaroxaban-based antithrombotic regimens reduce clinically significant bleeding compared to standard vitamin K antagonist plus DAPT.
In participants with atrial fibrillation undergoing PCI with placement of stents, the administration of either low-dose rivaroxaban plus a P2Y12 inhibitor for 12 months or very-low-dose rivaroxaban plus DAPT for 1, 6, or 12 months was associated with a lower rate of clinically significant bleeding than was standard therapy with a vitamin K antagonist plus DAPT for 1, 6, or 12 months. The three groups had similar efficacy rates, although the observed broad confidence intervals diminish the surety of any conclusions regarding efficacy. (Funded by Janssen Scientific Affairs and Bayer Pharmaceuticals; PIONEER AF-PCI ClinicalTrials.gov number, NCT01830543 .).
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C. Michael Gibson
Roxana Mehran
Christoph Bode
New England Journal of Medicine
University of Edinburgh
Icahn School of Medicine at Mount Sinai
University of Birmingham
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Gibson et al. (Mon,) studied this question.
www.synapsesocial.com/papers/69d5707d75589c71d767dc79 — DOI: https://doi.org/10.1056/nejmoa1611594