Antithrombotic Therapy after Acute Coronary Syndrome or PCI in Atrial Fibrillation

• Published in: The New England journal of medicine Vol. 380; no. 16; pp. 1509 - 1524
• Main Authors: Lopes, Renato D, Heizer, Gretchen, Aronson, Ronald, Vora, Amit N, Massaro, Tyler, Mehran, Roxana, Goodman, Shaun G, Windecker, Stephan, Darius, Harald, Li, Jia, Averkov, Oleg, Bahit, M. Cecilia, Berwanger, Otavio, Budaj, Andrzej, Hijazi, Ziad, Parkhomenko, Alexander, Sinnaeve, Peter, Storey, Robert F, Thiele, Holger, Vinereanu, Dragos, Granger, Christopher B, Alexander, John H
• Format: Journal Article
• Language: English
• Published: United States Massachusetts Medical Society 18-04-2019
• Subjects: Acute Coronary Syndrome - complications; Acute Coronary Syndrome - therapy; Acute coronary syndromes; Aged; Aged, 80 and over; Anticoagulants; Anticoagulants - adverse effects; Anticoagulants - therapeutic use; Aspirin; Aspirin - adverse effects; Aspirin - therapeutic use; Atrial Fibrillation - complications; Atrial Fibrillation - drug therapy; Bleeding; Cardiac arrhythmia; Clinical outcomes; Death; Disease management; Double-Blind Method; Drug Therapy, Combination; Electrocardiography; Factor Xa Inhibitors - adverse effects; Factor Xa Inhibitors - therapeutic use; Female; Fibrillation; Hemorrhage - chemically induced; Humans; Ischemia; Male; Middle Aged; Percutaneous Coronary Intervention; Platelet Aggregation Inhibitors - therapeutic use; Purinergic P2Y Receptor Antagonists - therapeutic use; Pyrazoles - adverse effects; Pyrazoles - therapeutic use; Pyridones - adverse effects; Pyridones - therapeutic use; Stroke; Vitamin K; Vitamin K - antagonists & inhibitors
• ISSN: 0028-4793; 1533-4406; 1533-4406
• DOI: 10.1056/NEJMoa1817083

The prevention of stroke and restenosis of coronary arteries in patients with atrial fibrillation who have an acute coronary syndrome or undergo percutaneous coronary intervention relies on antithrombotic therapy. In a two-by-two factorial, randomized trial, apixaban plus clopidogrel was more effective than a vitamin K antagonist, with or without aspirin.