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[The Experience of Use Triple Antithrombotic Therapy in Patients With Acute Coronary Syndrome and Atrial

N G Lozhkina1, M H Hasanova1, E A Glebchenko1

  • 1Novosibirsk State Medical University, Novosibirsk, Russia.

Kardiologiia
|August 2, 2017
PubMed

Insights

Apixaban combined with dual antiplatelet therapy effectively prevented stroke and embolism in atrial fibrillation patients post-acute coronary syndrome. This combination demonstrated a safe profile with minimal bleeding events over three months.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Non-valvular atrial fibrillation (NVAF) increases stroke risk.
  • Acute coronary syndrome (ACS) necessitates antiplatelet therapy.
  • Managing dual-pathology patients requires balancing antithrombotic and bleeding risks.

Purpose of the Study:

  • To evaluate the real-world effectiveness and safety of apixaban with dual antiplatelet therapy (DAPT).
  • To assess stroke and systemic embolism prevention in NVAF patients with recent ACS (without ST-segment elevation).

Main Methods:

  • An observational study involving 8 patients with NVAF and recent ACS (8-14 days post-symptom onset).
  • Apixaban (5 mg or 2.5 mg BID) combined with DAPT.
  • Effectiveness outcomes: deaths, stroke, systemic embolism.
  • Safety outcomes: major and clinically significant bleeding events.
  • Follow-up duration: 3 months.

Main Results:

  • No strokes, systemic embolism, or deaths were recorded during the 3-month observational period.
  • Two patients experienced minor, non-intervened hemorrhages (nasal, gingival) within the first month.
  • Two patients presented with non-permanent petechiae.
  • No major or clinically significant bleeding events occurred.

Conclusions:

  • Apixaban (5 mg or 2.5 mg BID) plus DAPT is effective and safe for preventing stroke and systemic embolism in NVAF patients with recent ACS.
  • The treatment demonstrated a favorable safety profile with minimal bleeding over 3 months.
  • Further research is warranted to confirm these findings in larger cohorts.
Abstract

Keywords:
acute coronary syndrome without ST segment elevationapixabanatrial fibrillationsystemic embolis

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