Management of patients with atrial fibrillation after percutaenous coronarography intervention: results of the trial AUGUSTUS

• Pavlova Tatyana V.
• Vorontsova Sofia A.
• Duplyakov Dmitriy V.

Abstract

Majority of patients with atrial fibrillation require long-term or even lifelong anticoagulant therapy. However, warfarin administration has a number of limitations, which can significantly affect the efficiency and safety of treatment. Direct oral anticoagulants are characterized by significantly reduced risk of bleeding compared to warfarin, which makes them drugs of choice in a number of clinical situations. The superior safety of these drugs was also proved in atrial fibrillation/ acute coronary syndrome co-infected patients and/or percutaenous coronarography intervention as a part of combined antithrombotic therapy. Results of multicentre randomized clinical trials PIONEER AF PCI, RE-DUAL PCI and AUGUSTUS have proved efficiency and safety of dual antiplatelet therapy (anticoagulant and antiaggregant) in comparison with traditional triple therapy (anticoagulant and dual antiplatelet therapy) on large clinical material. The AUGUSTUS study differed from the PIONEER AF PC and RE-DUAL PCI studies in a unique design with two-factor evaluation of two independent hypotheses. The results of this study established superior safety of apixaban in patients with atrial fibrillation and acute coronary syndrome and/or percutaenous coronarography intervention, to prove a decrease in number of hospitalizations without significant differences in ischemic events. Among direct oral anticoagulants only apixaban has evidence base for administration in course of triple antithrombotic therapy in patients with atrial fibrillation and acute coronary syndrome and/or percutaenous coronarography intervention.

Keywords:coronary heart disease, acute coronary syndrome, atrial fibrillation, percutaneous coronarography intervention, apixaban, dabigatran, rivaroxaban

All articles in our journal are distributed under the Creative Commons Attribution 4.0 International License (CC BY 4.0 license)