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Apixaban in AF patients with recent ACS/PCI: Drop aspirin after 30 days

Presented By
Prof. J. Alexander, Duke University, USA

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Conference
ACC 2020
Trial
AUGUSTUS
Patients with atrial fibrillation (AF) and recent acute coronary syndrome (ACS) and/or percutaneous coronary intervention (PCI) who receive a P2Y12 inhibitor are better off with apixaban than a vitamin K antagonist (VKA) as the use of aspirin for up to 30 days results in an equal trade-off between an increase in severe bleeding and reduction in severe ischaemic events [1]. The AUGUSTUS trial was a large, prospective, randomised trial with a two-by-two factorial design that showed that AF patients with recent ACS or PCI who used a P2Y12 inhibitor and apixaban had significantly less bleeding compared with warfarin (10.5% vs 14.7%, respectively; P<0.0001) [2]. No significant difference was seen between patients who received additional aspirin versus placebo in the secondary outcomes of composites death or hospitalisation and ischae...


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