Skip to main content
Top
Published in: Cardiovascular Drugs and Therapy 4/2019

01-08-2019 | Dabigatran | LETTER TO THE EDITOR

After the AUGUSTUS Trial, Should Apixaban Be the Only Direct Oral Anticoagulant to Be Used in Triple Therapy in Atrial Fibrillation Patients Undergoing Percutaneous Coronary Intervention?

Authors: Andrea Rubboli, Matteo Lisi

Published in: Cardiovascular Drugs and Therapy | Issue 4/2019

Login to get access

Excerpt

In patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention with stent (PCI), prospective, randomized evidence on the combination of a direct oral anticoagulant (DOAC) with the single antiplatelet agent clopidogrel (so-called double therapy) is [13], or soon will be [4], available for all four agents dabigatran, rivaroxaban, apixaban, and edoxaban [4]. Apixaban is currently the only DOAC being tested in combination with dual antiplatelet therapy (DAPT) of aspirin and clopidogrel (so-called triple therapy) in AF patients undergoing PCI [3]. Should therefore apixaban be the only DOAC to be used in triple therapy whenever this regimen is selected, and even when at the time of PCI the patient was in chronic oral anticoagulation (OAC) with another DOAC? …
Literature
1.
go back to reference Gibson CM, Mehran R, Bode C, Halperin J, Verheugt FW, Wildgoose P, et al. Prevention of bleeding in patients with atrial fibrillation undergoing PCI. N Engl J Med. 2016;375:2423–34. Gibson CM, Mehran R, Bode C, Halperin J, Verheugt FW, Wildgoose P, et al. Prevention of bleeding in patients with atrial fibrillation undergoing PCI. N Engl J Med. 2016;375:2423–34.
2.
go back to reference Cannon CP, Bhatt DL, Oldgren J, Lip GYH, Ellis SG, Kimura T, et al. RE-DUAL PCI steering committee and investigators. Dual antithrombotic therapy with dabigatran after PCI in atrial fibrillation. N Engl J Med. 2017;377:1513–24. Cannon CP, Bhatt DL, Oldgren J, Lip GYH, Ellis SG, Kimura T, et al. RE-DUAL PCI steering committee and investigators. Dual antithrombotic therapy with dabigatran after PCI in atrial fibrillation. N Engl J Med. 2017;377:1513–24.
3.
go back to reference Lopes RD, Heizer G, Aronson R, Vora AN, Massaro T, Mehran R, et al. AUGUSTUS Investigators. Antithrombotic therapy after acute coronary syndrome or PCI in atrial fibrillation. N Engl J Med. 2019;380:1509–24. Lopes RD, Heizer G, Aronson R, Vora AN, Massaro T, Mehran R, et al. AUGUSTUS Investigators. Antithrombotic therapy after acute coronary syndrome or PCI in atrial fibrillation. N Engl J Med. 2019;380:1509–24.
4.
go back to reference Vranckx P, Lewalter T, Valgimigli M, Tijssen JG, Reimitz PE, Eckardt L, et al. Evaluation of the safety and efficacy of an edoxaban-based antithrombotic regimen in patients with atrial fibrillation following successful percutaneous coronary intervention (PCI) with stent placement: rationale and design of the ENTRUST-AF PCI trial. Am Heart J. 2018;196:105–12. Vranckx P, Lewalter T, Valgimigli M, Tijssen JG, Reimitz PE, Eckardt L, et al. Evaluation of the safety and efficacy of an edoxaban-based antithrombotic regimen in patients with atrial fibrillation following successful percutaneous coronary intervention (PCI) with stent placement: rationale and design of the ENTRUST-AF PCI trial. Am Heart J. 2018;196:105–12.
5.
go back to reference Lip GYH, Collet JP, Haude M, Byrne R, Chung EH, Fauchier L, et al. ESC Scientific Document Group. 2018 Joint European consensus document on the management of antithrombotic therapy in atrial fibrillation patients presenting with acute coronary syndrome and/or undergoing percutaneous cardiovascular interventions: a joint consensus document of the European Heart Rhythm Association (EHRA), European Society of Cardiology Working Group on Thrombosis, European Association of Percutaneous Cardiovascular Interventions (EAPCI), and European Association of Acute Cardiac Care (ACCA) endorsed by the Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), Latin America Heart Rhythm Society (LAHRS), and Cardiac Arrhythmia Society of Southern Africa (CASSA). Europace. 2019;21:192–3 Lip GYH, Collet JP, Haude M, Byrne R, Chung EH, Fauchier L, et al. ESC Scientific Document Group. 2018 Joint European consensus document on the management of antithrombotic therapy in atrial fibrillation patients presenting with acute coronary syndrome and/or undergoing percutaneous cardiovascular interventions: a joint consensus document of the European Heart Rhythm Association (EHRA), European Society of Cardiology Working Group on Thrombosis, European Association of Percutaneous Cardiovascular Interventions (EAPCI), and European Association of Acute Cardiac Care (ACCA) endorsed by the Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), Latin America Heart Rhythm Society (LAHRS), and Cardiac Arrhythmia Society of Southern Africa (CASSA). Europace. 2019;21:192–3
6.
go back to reference Steffel J, Verhamme P, Potpara TS, Albaladejo P, Antz M, Desteghe L, et al. The 2018 European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation: executive summary. Europace. 2018;20:1231–42. Steffel J, Verhamme P, Potpara TS, Albaladejo P, Antz M, Desteghe L, et al. The 2018 European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation: executive summary. Europace. 2018;20:1231–42.
7.
go back to reference Angiolillo DJ, Goodman SG, Bhatt DL, Eikelboom JW, Price MJ, Moliterno DJ, et al. Antithrombotic therapy in patients with atrial fibrillation treated with oral anticoagulation undergoing percutaneous coronary intervention. Circulation. 2018;138:527–36. Angiolillo DJ, Goodman SG, Bhatt DL, Eikelboom JW, Price MJ, Moliterno DJ, et al. Antithrombotic therapy in patients with atrial fibrillation treated with oral anticoagulation undergoing percutaneous coronary intervention. Circulation. 2018;138:527–36.
8.
go back to reference Ruff CT, Giugliano RP, Braunwald E, Hoffman EB, Deenadayalu N, Ezekowitz MD, et al. Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials. Lancet. 2014;383:955–62. Ruff CT, Giugliano RP, Braunwald E, Hoffman EB, Deenadayalu N, Ezekowitz MD, et al. Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials. Lancet. 2014;383:955–62.
Metadata
Title
After the AUGUSTUS Trial, Should Apixaban Be the Only Direct Oral Anticoagulant to Be Used in Triple Therapy in Atrial Fibrillation Patients Undergoing Percutaneous Coronary Intervention?
Authors
Andrea Rubboli
Matteo Lisi
Publication date
01-08-2019
Publisher
Springer US
Published in
Cardiovascular Drugs and Therapy / Issue 4/2019
Print ISSN: 0920-3206
Electronic ISSN: 1573-7241
DOI
https://doi.org/10.1007/s10557-019-06886-w

Other articles of this Issue 4/2019

Cardiovascular Drugs and Therapy 4/2019 Go to the issue