JoVE - Journal of Visualized Experiments
JoVE Visualize
Contact Us

Randomized Comparison of Progression of Atherosclerotic Plaques and Calcification of Coronary Artery in Atrial Fibrillation Patients Treated With Edoxaban Versus Warfarin (The REPRESENT-AF trial)

  • 0Division of Cardiology, Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea; Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea.
The American Journal of Cardiology +

|

August 9, 2024

|

August 9, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

Edoxaban did not significantly alter coronary plaque or calcification compared to warfarin in atrial fibrillation patients. Both anticoagulants, with statin therapy, reduced plaque volume over 12 months.

Area Of Science

  • Cardiology
  • Pharmacology
  • Vascular Biology

Background

  • Warfarin, a vitamin K oral anticoagulant, has known adverse effects on coronary vasculature.
  • The impact of non-vitamin K oral anticoagulants (NOACs) on coronary plaque progression and calcification is not well understood.
  • Atrial fibrillation (AF) patients often have coexisting coronary atherosclerosis.

Purpose Of The Study

  • To compare changes in coronary atherosclerotic plaque and calcification in AF patients treated with edoxaban versus warfarin.
  • To evaluate the efficacy of edoxaban in attenuating plaque progression and calcification compared to warfarin.

Main Methods

  • 150 OAC-naïve AF patients with coronary lesions were randomized to edoxaban or warfarin.
  • All patients received rosuvastatin 10 mg.
  • Coronary computed tomography angiography (CCTA) was performed at baseline and 12 months to analyze plaque and calcium volumes.

Main Results

  • Both edoxaban and warfarin significantly reduced plaque volume over 12 months, with no significant difference between groups.
  • Coronary calcium volume increased more in the warfarin group, but this difference was not statistically significant.
  • Edoxaban did not demonstrate a superior effect on atherosclerotic plaques or coronary calcification compared to warfarin.

Conclusions

  • In OAC-naïve AF patients with coronary lesions on moderate-intensity statin, edoxaban showed comparable effects to warfarin on plaque regression and calcification over 12 months.
  • Neither edoxaban nor warfarin demonstrated a significant impact on coronary calcification progression in this patient cohort.
  • Further research is needed to elucidate the long-term vascular effects of NOACs in AF patients with coronary artery disease.

Keywords: