Antithrombotic Strategies in Atrial Fibrillation After Acute Coronary Syndrome (ACS) and/or Percutaneous Coronary Intervention (PCI): A 4-Way Comparison From AUGUSTUS
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
Methodological detailsmulticentre, 2 × 2 factorial, 4-way analysis
- Multicentre
- 2 × 2 factorial
- 4-way analysis
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: A 4-Way Comparison From AUGUSTUS. J Am Coll Cardiol. Published 3 September 2024. doi:10.
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