"AUGUSTUS - Dual Therapy with Apixaban, P2Y12 Inhibitor Safe in Afib Patients Post-ACS or PCI"
New data from the AUGUSTUS trial provide insight on the appropriate antithrombotic regimen after ACS or PCI in patients with atrial fibrillation. According to Roxana Mehran, MD, professor of medicine and cardiology at the Icahn School of Medicine at Mount Sinai, “this was the largest trial in patients who require an oral anticoagulant and present with ACS or have a need for PCI.” Dr. Mehran said the trial was able to show that apixaban was superior in reduction in bleeding events compared with vitamin K antagonists and aspirin withdrawal in these patients with AF undergoing PCI who require another antiplatelet regimen plus an oral anticoagulant will reduce bleeding by 90 percent. “The trial was not powered for the important rare ischemic events that may occur in this population. I don’t think we can say an oral anticoagulant plus a P2Y12 inhibitor without aspirin is the optimal therapy for 100 percent of these patients, but we can for a large majority of them, which is a giant leap forward.”
— Roxana Mehran, MD, Professor, Medicine, Cardiology, Population Health Science and Policy, Icahn School of Medicine at Mount Sinai