Arrhythmias & electrophysiology
Impact of renal function on edoxaban antithrombotic therapy in patients with atrial fibrillation and stable coronary artery disease: a prespecified analysis of the EPIC-CAD trial
Authors' conclusion
In patients with AF and stable CAD, edoxaban monotherapy led to a lower risk of primary NACE than dual antithrombotic therapy, regardless of renal function. (ClinicalTrials.gov: NCT03718559).
Study context
- Population
- Patients with atrial fibrillation (AF) and stable coronary artery disease (CAD) undergoing antithrombotic therapy, stratified by creatinine clearancelow creatinine clearance (<50 mL/min) 252 · high creatinine clearance (≥50 mL/min) 788
- Participants
- 1,040 randomised patients
- Comparison
- edoxaban monotherapy or dual antithrombotic therapy (edoxaban plus a single antiplatelet agent), by creatinine clearance group
- low creatinine clearancen = 252
- high creatinine clearancen = 788reference
- Primary endpoint
- net adverse clinical events:
- NACE: death from any cause
- Myocardial infarction
- Stroke
- Systemic embolism
- Urgent revascularisation
- Major/clinically relevant non-major bleeding
- Follow-up
- 12 months
Methodological detailsrandomised
- Randomised
Primary result
As reported in the abstract
Net adverse clinical events:
- NACE: death from any cause
- Myocardial infarction
- Stroke
- Systemic embolism
- Urgent revascularisation
- Major/clinically relevant non-major bleeding
edoxaban monotherapy vs dual antithrombotic therapyHazard ratio (95% CI)P value
Low creatinine clearance group: 12.1% vs 21.7%
0.52(0.28–0.98)
P = 0.042High creatinine clearance group: 5.2% vs 14.5%
0.40(0.25–0.65)
P < 0.001Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| NACE, ischaemic events and bleeding by creatinine clearance · NACE | 1.72 (1.19–2.49) | P = 0.004 | |
| NACE, ischaemic events and bleeding by creatinine clearance · ischaemic events | 2.70 (1.09–6.70) | P = 0.032 | |
| NACE, ischaemic events and bleeding by creatinine clearance · bleeding | 1.54 (1.01–2.34) | P = 0.046 | |
| 0.10.31310Hazard ratio (log scale) |
| Outcome | Edoxaban monotherapy | Dual antithrombotic therapy | Low creatinine clearance | High creatinine clearance | Estimate | P value | |
|---|---|---|---|---|---|---|---|
| Baseline characteristics by creatinine clearance | Not reported in the abstract | Not reported in the abstract | 24.2% | 75.8% | edoxaban monotherapy, dual antithrombotic therapy: not reported in the abstract |
Baseline characteristics by creatinine clearance
- Low creatinine clearance patients were older and had more comorbidities
Original publication
Impact of renal function on edoxaban antithrombotic therapy in patients with atrial fibrillation and stable coronary artery disease: a prespecified analysis of the EPIC-CAD trial. EuroIntervention. Published 20 April 2026. doi:10.
Summarised from the published abstract; every number is checked against it