In a finding that suggests less is more, researchers led by the Duke Clinical Research Institute (DCRI) found that the drugs apixaban and clopidogrel -- without aspirin -- comprise the safest treatment regimen for certain patients with atrial fibrillation (A-fib).
The finding -- which applies specifically to patients with A-fib who have had a heart attack and/or are undergoing percutaneous coronary intervention -- should reassure clinicians and patients that dropping aspirin results in no significant increase in ischemic events such as heart attacks, strokes and blood clots.
The researchers presented data from the large study, known as AUGUSTUS, on March 17 at the American College of Cardiology annual meeting. The research was also simultaneously published online by The New England Journal of Medicine.
“We have a lot of studies on antithrombotic drugs in patients with coronary artery disease and similarly in patients with A-fib, but few studies in patients with both conditions. The reality is that doctors and patients have a challenge in treating these patients without causing bleeding. The results of this trial give us an opportunity to better understand how to best treat them.” said cardiologist Renato D. Lopes, MD, PHD, MHSC, and principal investigator for the trial.