Coronary disease & ACSSecondary analysis
Antithrombotic Therapy to Minimize Total Events After Acute Coronary Syndrome (ACS) or Percutaneous Coronary Intervention (PCI) in Atrial Fibrillation
- Secondary analysis of the AUGUSTUS randomised trial
- open-label
- 2×2 factorial
Authors' conclusion
Among patients with AF and recent ACS or PCI, apixaban significantly reduced total bleeding risk compared with VKA. Aspirin doubled total bleeding risk compared with placebo without a significant change in total ischemic events.
Study context
- Population
- Patients with atrial fibrillation (AF) and recent ACS or PCI on P2Y12 inhibitor therapyrandomized
- Participants
- 4,614 patients
- Comparison
- Apixaban vs vitamin K antagonist (VKA) and aspirin vs placebo
- Primary endpoint
- Total major or clinically relevant nonmajor bleeding events, total ischemic events and total hospitalizations
- Follow-up
- 6 months
Primary result
As reported in the abstract
Total bleeding
Relative risk (95% CI)
Apixaban vs VKA
0.66(0.55–0.80)
Aspirin vs Placebo
2.14(1.75–2.60)
Further findings
| Outcome | RR (95% CI) | |
|---|---|---|
| Total ischemic events — Apixaban vs VKA | 0.83 (0.58–1.20) | |
| Total ischemic events — Aspirin vs Placebo | 0.75 (0.52–1.08) | |
| Total hospitalizations — Apixaban vs VKA | 0.90 (0.79–1.03) | |
| Total hospitalizations — Aspirin vs Placebo | 1.11 (0.97–1.27) | |
| 0.512Relative risk (log scale) |
- Total ischemic events: ≥1 ischemic event: 219 (4.7%); 75 (34.2%) of them multiple
- Total hospitalizations: ≥1 hospitalization: 1,125 (24.4%); 384 (34.1%) of them multiple
Original publication
Antithrombotic Therapy to Minimize Total Events After ACS or PCI in Atrial Fibrillation. J Am Coll Cardiol. Published 5 February 2025. doi:10.1016/j.jacc.2024.10.125
Summarised from the published abstract; every number is checked against it