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Pearl Toh, 3 days ago
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DOAC plus DAPT cuts risk of bleeding in AF patients with coronary disease

06 Oct 2018
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Direct oral anticoagulants (DOACs) in combination with dual antiplatelet therapy (DAPT), compared with vitamin K antagonists (VKAs), correlate with a reduced risk of bleeding and similar thromboembolic protection in atrial fibrillation (AF) patients with myocardial infarction (MI) and/or after percutaneous coronary intervention (PCI), a recent study has shown.

Of the 3,222 patients included in the study, 875 (27 percent) were treated with VKA+single antiplatelet therapy (SAPT), 595 (18 percent) with DOAC+SAPT, 1,074 (33 percent) with VKA+DAPT and 678 (22 percent) with DOAC+DAPT.

A significant difference was observed at 3 months in the absolute risk of MI associated with DOAC+SAPT vs VKA+SAPT (3-month absolute risk difference [ARD], –1.53; 95 percent CI, –3.08 percent to –0.11 percent). There were no significant differences regarding bleeding, ischaemic stroke and all-cause mortality.

DOAC+DAPT correlated with a significantly reduced risk of bleeding (3-month ARD, –1.96; –3.46 percent to –0.88 percent) compared with VKA+DAPT, with no significant difference in the absolute risk of all-cause mortality, stroke or MI.

In this study, the investigators used Danish nationwide registries to identify AF patients who were admitted with a MI and/or underwent PCI, between August 2011 and June 2017, treated with oral anticoagulant in combination with antiplatelets (ie, aspirin, clopidogrel or both). They followed patients for 12 months or until an outcome, study end or death.

Based on outcome-specific Cox regression models adjusted for potential confounders, the investigators estimated standardized absolute risks. They used the g-formula to obtain average treatment effects as standardized ARD in risks at 3 and 12 months.

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Most Read Articles
Pearl Toh, 3 days ago
A latest study at ISC 2019 shows that even patients with large-core stroke damage can have a good outcome after mechanical clot removal with endovascular thrombectomy (EVT), depending on the size of the infarct and time lapses between stroke onset and treatment.
26 Dec 2017
Supplementation with omega-3 fatty acids in combination with rosuvastatin may yield significant reductions in triglycerides and nonhigh-density lipoprotein (HDL) cholesterol as compared with rosuvastatin monotherapy, according to data from the ROMANTIC (rosuvastatin-omacor in residual hypertriglyceridemia) trial.
24 Aug 2016

Roshini Claire Anthony spoke with Adjunct Associate Professor Gamaliel Tan, head and senior orthopaedic consultant at Ng Teng Fong Hospital in Singapore, on how GPs can help diagnose and treat lower back pain.

Rachel Soon, 12 Dec 2018

MIMS Pharmacist presents an overview of superoxide dismutase (SOD) and its role in resisting the effects of oxidative stress and aging.