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Published on: February 28, 2012

Efficacy of 15 mg Edoxaban on Long-Term Outcome after Percutaneous Coronary Intervention in Patients with Atrial

Takao Sato1, Yoshifusa Aizawa2, Toshihiro Miyamoto1

  • 1Department of Cardiology, International University of Health and Welfare Narita Hospital.

International Heart Journal
|July 15, 2026
PubMed

Insights

For older patients with atrial fibrillation (AF) after percutaneous coronary intervention (PCI), low-dose edoxaban (15 mg) did not show superiority over the standard dose (30 mg) for preventing thrombotic or bleeding events. Further research is needed to clarify optimal dosing strategies.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Dual antiplatelet therapy (DAPT) plus oral anticoagulants increase bleeding risk in atrial fibrillation (AF) patients undergoing percutaneous coronary intervention (PCI).
  • Low-dose edoxaban (15 mg) is established for high-risk AF patients, but its efficacy post-PCI compared to the standard 30 mg dose is not well-defined.

Purpose of the Study:

  • To compare the safety and efficacy of 15 mg versus 30 mg edoxaban in patients with AF following PCI.

Main Methods:

  • Retrospective analysis of AF patients undergoing PCI for acute coronary syndrome, treated with either 15 mg (n=49) or 30 mg (n=99) edoxaban.
  • Assessment of bleeding and thrombotic events over two years, alongside clinical risk scores (CHADS2, HAS-BLED, CREDO-Kyoto).
  • Weighted Cox regression analysis was used to compare outcomes between the two dosage groups.

Main Results:

  • Patients on 15 mg edoxaban were older, had lower hemoglobin and BMI, and higher CHADS2, HAS-BLED, and CREDO-Kyoto scores.
  • Major bleeding events were numerically lower in the 15 mg group (6.8%) compared to the 30 mg group (19.7%), but this difference was not statistically significant (P=0.08).
  • Thrombotic events were comparable between the groups (3.0% vs 7.4%, P=0.35).

Conclusions:

  • In older, high bleeding-risk AF patients post-PCI, 15 mg edoxaban did not demonstrate statistically significant superiority over 30 mg edoxaban in reducing thrombotic or bleeding events.
  • The study suggests that while numerically lower, the 15 mg dose may not offer a significant advantage in this specific high-risk population.
  • Further prospective studies are warranted to establish optimal edoxaban dosing in AF patients undergoing PCI.

Keywords:
Direct oral anticoagulantDual antiplatelet therapy

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