Coronary disease & ACSSecondary analysis
Antithrombotic Strategies in Atrial Fibrillation After Acute Coronary Syndrome (ACS) and/or Percutaneous Coronary Intervention (PCI)
- Secondary analysis of the AUGUSTUS randomised trial
- multicentre
- 2 × 2 factorial
- 4-way analysis
Authors' conclusion
In patients with AF and a recent ACS and/or PCI, an antithrombotic regimen that included a P2Y12 inhibitor and apixaban without aspirin resulted in a lower incidence of the composite of death, bleeding, or cardiovascular hospitalization than regimens including VKA, aspirin, or both.
Study context
- Population
- Patients with atrial fibrillation (AF) with recent ACS and/or PCI treated with a P2Y12 inhibitor
- Participants
- 4,614 patients
- Comparison
- Apixaban vs vitamin K antagonist (VKA) and aspirin vs placebo, each with a P2Y12 inhibitor
- Primary endpoint
- Composite of:
- All-cause death
- Major or clinically relevant nonmajor bleeding
- Hospitalization for CV causes
- Follow-up
- 6-month follow-up
Primary result
As reported in the abstract
Secondary outcomes
Major or clinically relevant nonmajor bleeding; hospitalization for CV causes
- Lower with apixaban and placebo vs the other 3 strategies
All-cause death
- No difference between the 4 randomized groups
Original publication
Antithrombotic Strategies in Atrial Fibrillation After ACS and/or PCI. J Am Coll Cardiol. Published 3 September 2024. doi:10.1016/j.jacc.2024.06.022
Summarised from the published abstract; every number is checked against it