Condition: Acute Coronary Syndrome · Myocardial Infarction · Atrial Fibrillation · Sponsor: St. Antonius Hospital
The optimal antithrombotic management in patients with coronary artery disease (CAD) and concomitant atrial fibrillation (AF) is unknown. AF patients are treated with oral anticoagulation (OAC) to prevent ischemic stroke and systemic embolism and patients undergoing percutaneous coronary intervention (PCI) are treated with dual antiplatelet therapy (DAPT), i.e. aspirin plus P2Y12 inhibitor, to prevent stent thrombosis (ST) and myocardial infarction (MI). Patients with AF undergoing PCI were traditionally treated with triple antithrombotic therapy (TAT, i.e. OAC plus aspirin and P2Y12 inhibitor) to prevent ischemic complications. However, TAT doubles or even triples the risk of major bleeding complications. More recently, several clinical studies demonstrated that omitting aspirin, a strategy known as dual antithrombotic therapy (DAT) is safer compared to TAT with comparable efficacy. However, pooled evidence from recent meta-analyses suggests that patients treated with DAT are at increased risk of MI and ST. Insights from the AUGUSTUS trial showed that aspirin added to OAC and clopidogrel for 30 days, but not thereafter, resulted in fewer severe ischemic events. This finding emphasizes the relevance of early aspirin administration on ischemic benefit, also reflected in the current ESC guideline. However, because we consider the bleeding risk of TAT unacceptably high, we propose to use a short course of DAPT (omitting OAC for 1 month). There is evidence from the BRIDGE study …
This description comes directly from the study's public registry record.
Ashley Verburg, MD · +31 (0)88 320 0925 · as.verburg@antoniusziekenhuis.nl
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| ASZ Aalst | Aalst, Belgium | Recruiting |
| UZ Antwerpen | Antwerp, Belgium | Recruiting |
| Imelda Ziekenhuis | Bonheiden, Belgium | Recruiting |
| UZ Brussel | Brussels, Belgium | Recruiting |
| Ziekenhuis Oost-Limburg | Genk, Belgium | Recruiting |
| AZ Maria Middelares Gent | Ghent, Belgium | Recruiting |
| Jan Yperman | Ieper, Belgium | Not Yet Recruiting |
| AZ Groeninge | Kortrijk, Belgium | Recruiting |
| UZ Leuven | Leuven, Belgium | Recruiting |
| AZ Delta | Roeselare, Belgium | Recruiting |
| Noordwest Ziekenhuisgroep | Alkmaar, Netherlands | Recruiting |
| Amsterdam UMC | Amsterdam, Netherlands | Recruiting |
+ 8 more locations — full list on the registry record.
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Source record: clinicaltrials.gov/study/NCT04436978