AUGUSTUS
Antithrombotic Therapy after Acute Coronary Syndrome or PCI in Atrial Fibrillation
Patient / Population Intervention / Exposure Comparison Outcome
In 4,614 patients with AF and recent ACS or PCI, apixaban without aspirin reduced major or clinically relevant bleeding compared with warfarin-based triple therapy.
N
4,614
Design
2×2 factorial RCT
Endpoint
Major or clinically relevant non-major bleeding
Relevance
1
ResultApixaban vs warfarin HR 0.69; aspirin vs placebo HR 1.89 for bleeding.
Lopes RD, et al. N Engl J Med. 2019;380(16):1509-1524. 10.1056/NEJMoa1817083
Discussion & critique
Established apixaban plus a P2Y12 inhibitor without aspirin as the default. Triple therapy is now limited to roughly the first week after PCI.