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Rivaroxaban Monotherapy in Patients With Atrial Fibrillation After Coronary Stenting

Authors :
Tetsuya Matoba
Satoshi Yasuda
Koichi Kaikita
Masaharu Akao
Junya Ako
Masato Nakamura
Katsumi Miyauchi
Nobuhisa Hagiwara
Kazuo Kimura
Atsushi Hirayama
Kunihiko Matsui
Hisao Ogawa
Yukihiro Koretsune
Takafumi Hiro
Tetsuya Sumiyoshi
Kazumi Kimura
Yoichiro Hashimoto
Teruyuki Hirano
Hiroyuki Daida
Yasushi Okada
Tsutomu Yamazaki
A. Nakamura
E. Tamiya
T. Yamamoto
S. Suetake
T. Noguchi
S. Nakamura
A. Matsumura
J. Kojima
S. Suwa
H. Yamaguchi
K. Kaikita
T. Yasu
A. Nakajima
T. Yamada
H. Arai
Y. Hata
T. Sakanashi
H. Tateishi
T. Nakayama
Y. Nozaki
M. Akao
Y. Okumura
M. Tokue
N. Kuroki
Y. Maruyama
T. Matoba
N. Hagiwara
H. Suzuki
Y. Nishida
M. Ajioka
K. Yumoto
S. Shimizu
T. Aoyama
H. Shimomura
T. Takeda
K. Oshiro
N. Sugishita
Y. Shibata
T. Otonari
H. Kihara
H. Ogawa
A. Ohno
M. Hazama
M. Shimizu
K. Tsukahara
S. Haruta
T. Wakeyama
T. Haruna
M. Ito
K. Fujii
N. Atsuchi
M. Sata
K. Kimura
N. Hasebe
Y. Kobayasi
K. Ohsato
K. Hironaga
Y. Naganuma
K. Anzaki
K. Oiwa
S. Okazaki
Y. Nakagawa
K. Tokuhiro
K. Tanaka
T. Momose
Y. Fukushima
R. Kametani
K. Kawamitsu
Y. Saito
S. Akashi
K. Kumagai
K. Eshima
T. Tobaru
T. Seo
K. Okuhara
K. Kozuma
Y. Ikari
T. Takahashi
I. Michishita
H. Fujikura
S. Momomura
Y. Yamamoto
K. Otomo
T. Matsubara
H. Tashiro
T. Inoue
M. Ishihara
I. Shiojima
E. Tachibana
J. Ako
K. Sumii
N. Yamamoto
N. Ohmura
T. Nakamura
Y. Morita
N. Takahashi
K. Watanabe
H. Fujinaga
M. Maruyama
T. Oka
T. Shirayama
T. Amano
K. Fukui
K. Ando
S. Oshima
S. Kagiyama
H. Teragawa
M. Yuge
S. Ono
T. Koga
K. Fujiu
M. Kuwabara
Y. Ohya
Y. Yumoto
N. Kuji
M. Ikemura
K. Kario
K. Chatani
K. Sato
H. Miyagi
M. Murakami
K. Saito
M. Hoshiga
S. Sato
N. Kubo
Y. Sakamoto
K. Ashida
H. Sakamoto
S. Murasaki
H. Uehara
T. Akasaka
Y. Ooba
S. Nakahara
Y. Hanaoka
T. Nishimiya
R. Tsunoda
Y. Onuma
S. Higuchi
A. Tani
A. Wada
M. Kato
H. Obata
Y. Higuchi
T. Endo
R. Katou
T. Matsunaga
T. Matsuoka
H. Noguchi
M. Usui
T. Hayashi
Y. Otsuji
T. Osaki
H. Zaizen
H. Yoshihara
K. Kadota
T. Hirose
T. Miyazawa
A. Mori
M. Takano
W. Shimizu
M. Wake
S. Oriso
M. Yoshiyama
S. Kakinoki
T. Nishioka
T. Ozaki
K. Nomoto
K. Seki
K. Kawai
Y. Ozaki
S. Miura
M. Kawasaki
R. Funada
K. Dote
T. Nagano
S. Okamoto
T. Kubo
Y. Murozono
T. Owada
T. Doke
T. Matsumura
M. Horiuchi
A. Takaishi
M. Yamamoto
H. Nakashima
M. Munemasa
Y. Sakata
N. Inoue
T. Ota
Y. Hamano
N. Abe
T. Tsubokura
M. Goto
I. Kubota
M. Yano
K. Umetani
T. Date
H. Morimoto
T. Noda
S. Goto
K. Hibi
A. Nakano
S. Hiramitsu
Y. Kihara
M. Sugi
N. Shiba
D. Izumi
T. Sato
S. Tayama
T. Matsui
A. Suzuki
K. Ajiki
M. Oishi
M. Kiryu
T. Ko
H. Ando
S. Miyazaki
T. Kinugawa
H. Otake
H. Kitaoka
Y. Hirata
S. Honda
M. Manita
Y. Ishii
H. Oka
Y. Nanba
M. Nishino
T. Sakamoto
T. Saito
H. Sakai
M. Ichikawa
S. Namiuchi
K. Inoue
N. Komiyama
Y. Akashi
Y. Nakamura
T. Komaru
T. Hosokawa
T. Chikamori
H. Tanaka
O. Arasaki
K. Aonuma
Y. Wakasa
T. Yoshizawa
T. Sugano
N. Yokota
A. Kakutani
T. Suzuki
Y. Abe
T. Kataoka
H. Okayama
H. Yokoi
K. Chin
K. Hasegawa
H. Tomita
H. Honzyo
H. Kawai
K. Yamamoto
Y. Morino
S. Tsujiyama
S. Hamasaki
Y. Niijima
Y. Mizuno
A. Maki
K. Tanabe
T. Murohara
S. Naomi
M. Arikawa
T. Kato
N. Matsumoto
T. Minamino
H. Sairenji
N. Miyamoto
H. Ito
Y. Matsuura
S. Hata
Y. Nakatsu
T. Onodera
M. Yoshimura
H. Amano
E. Tokutake
M. Kasao
M. Moriguchi
M. Tsuji
H. Yamamoto
Y. Yanbe
T. Iwasawa
M. Suzuki
H. Mori
Source :
JACC: Cardiovascular Interventions. 14:2330-2340
Publication Year :
2021
Publisher :
Elsevier BV, 2021.

Abstract

Objectives The aim of this AFIRE (Atrial Fibrillation and Ischemic Events With Rivaroxaban in Patients With Stable Coronary Artery Disease) trial subgroup analysis was to examine rivaroxaban monotherapy benefits and their relation to the time between stenting and enrollment among patients after coronary stenting. Background Of 2,215 patients with atrial fibrillation and stable coronary artery disease in the AFIRE trial, rivaroxaban monotherapy was noninferior to rivaroxaban plus antiplatelet therapy (combination therapy) in terms of efficacy and superior for safety endpoints. However, thrombotic risk after antiplatelet therapy cessation remained a concern among 1,444 patients who had undergone coronary stenting >1 year before enrollment. Methods The benefits of rivaroxaban monotherapy in coronary stenting subgroups were assessed for efficacy (a composite of stroke, systemic embolism, myocardial infarction, unstable angina requiring revascularization, or death of any cause), safety (major bleeding defined according to International Society on Thrombosis and Haemostasis criteria), ischemic endpoints, net adverse clinical event, and time between stenting and enrollment. Results Efficacy and safety endpoints for monotherapy were superior to combination therapy, with HRs of 0.70 for efficacy (95% CI: 0.50-0.98; P = 0.036) and 0.55 for safety (95% CI: 0.33-0.92; P = 0.019). For ischemic endpoints, the HR was 0.82 (95% CI: 0.58-1.15; P = 0.240). The HR became smaller with longer time between stenting and enrollment (efficacy, P for interaction = 0.158; safety, P = 0.097). Conclusions In patients with atrial fibrillation after coronary stenting, the benefits of rivaroxaban monotherapy for efficacy and safety endpoints were consistent with those in the whole AFIRE trial population. The benefits became apparent with longer time between stenting and enrollment. (Atrial Fibrillation and Ischemic Events With Rivaroxaban in Patients With Stable Coronary Artery Disease Study [AFIRE]; UMIN000016612 , NCT02642419 )

Details

ISSN :
19368798
Volume :
14
Database :
OpenAIRE
Journal :
JACC: Cardiovascular Interventions
Accession number :
edsair.doi...........d6b50dfa262910fe5aa979d3e9bbcde2
Full Text :
https://doi.org/10.1016/j.jcin.2021.07.045