Stable coronary disease with atrial fibrillation

Stable coronary disease with atrial fibrillation: anticoagulants alone or in combination with an antiplatelet agent?

In patients with atrial fibrillation (AF) and stable coronary disease (not requiring revascularisation or revascularised for > 1 year), treatment combining a direct oral anticoagulant (DOAC; rivaroxaban) with an antiplatelet agent (APA) has, compared to a DOAC alone, a risk/benefit ratio which is:

• A

  Unfavourable
• B

  Comparable
• C

  Favourableς, η σωστή απάντηση είναι η εξής Unfavourable

Περισσότερα

An open-label randomised controlled trial included 2,200 Japanese subjects of this type and was stopped early due to increased overall mortality in the DOAC + APA (aspirin or P2Y12 inhibitor) arm, compared to the DOAC alone (3.37% vs. 1.85% per patient-year, respectively), essentially due to an increased rate of major bleeding (2.76% vs. 1.62% per patient-year). The combined treatment was more effective than the monotherapy (composite endpoint of cardiovascular events and mortality), but the difference was non-inferior based on a pre-defined threshold.

Source: Antithrombotic Therapy for Atrial Fibrillation with Stable Coronary Disease

https://www.nejm.org/doi/full/10.1056/NEJMoa1904143

Categories: iatrika