Open AccessSubanalysis of the AUGUSTUS trial
Author(s) -
Т. В. Павлова,
П. Д. Дуплякова,
О. В. Шкаева,
С. П. Кривова
Publication year - 2020
Publication title -
rossijskij kardiologičeskij žurnal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.141
H-Index - 14
eISSN - 2618-7620
pISSN - 1560-4071
DOI - 10.15829/1560-4071-2020-4104
Subject(s) - medicine , acute coronary syndrome , atrial fibrillation , warfarin , percutaneous coronary intervention , rivaroxaban , apixaban , coronary artery disease , vitamin k antagonist , comorbidity , cardiology , clinical trial , randomized controlled trial , intensive care medicine , myocardial infarction
Comorbidity is a common feature of a modern patient. The combination of atrial fibrillation (AF) and various types of coronary artery disease is widespread in actual clinical practice. In such cases, additional pathophysiological mechanisms appear that worsen the clinical course and patient’s prognosis. The management of AF patients who have undergone acute coronary syndrome and/or percutaneous coronary intervention is a challenging problem, which can be solved by large-scale clinical trials. The AUGUSTUS randomized trial with a two-by-two factorial design proved that full-dose apixaban is superior in safety to the vitamin K antagonist warfarin, while not inferior in effectiveness. This pattern has been preserved in several important subanalysis on stent thrombosis, hospitalization rates, and conservative management of acute coronary syndrome. The obtained results are included in the novel European Society of Cardiology guidelines on AF.