A Matter of Timing: Antithrombosis Strategies Stratified by Time After ACS or PCI in Patients with Atrial Fibrillation

Taken together with previous study findings, these results should spell the end to long-term triple therapy in most patients.

In the AUGUSTUS randomized, controlled trial (RCT; NCT02415400; NEJM JW Cardiol May 2019 and N Engl J Med 2019; 380:1509), investigators randomized 4614 patients with atrial fibrillation who had a recent acute coronary syndrome (ACS) or percutaneous coronary intervention (PCI) to receive standard-dose apixaban or vitamin K antagonist (VKA) within 14 days after ACS/PCI. In addition, all patients received a P2Y₁₂ antagonist and were randomized to aspirin or placebo. Apixaban and P2Y₁₂ antagonist without aspirin showed the best results.

In a secondary analysis of those trial data, researchers stratified outcomes by time frames of 0 to 30 days and 30 days to 6 months. The endpoints included three composite bleeding outcomes and three composite i…

Reviewing Author

Mark S. Link, MD

Disclosures

Editorial BoardsCirculation; UpToDate

Mark S. Link, MD

Disclosures

Editorial BoardsCirculation; UpToDate

A Matter of Timing: Antithrombosis Strategies Stratified by Time After ACS or PCI in Patients with Atrial Fibrillation

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Reviewing Author