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Rivaroxaban monotherapy non-inferior to combination therapy in AF and stable CAD patients

Expert
Dr Satoshi Yasuda, National Cerebral and Cardiovascular Centre, Japan
Conference
ESC 2019
Trial
AFIRE

Data from the AFIRE study showed that oral anticoagulant monotherapy with rivaroxaban was superior to combination therapy with regard to both safety and efficacy. These findings support guideline recommendation of oral anticoagulant monotherapy for this population.

The Japanese AFIRE study researched whether rivaroxaban monotherapy is non-inferior to combination therapy (rivaroxaban + antiplatelet agent) in atrial fibrillation (AF) patients with stable coronary artery disease (CAD) who did not require percutaneous coronary intervention (PCI) or more than 1 year after PCI or coronary artery bypass grafting (CABG) [1]. A total of 2,236 patients were randomised to either rivaroxaban monotherapy or combination therapy (rivaroxaban + antiplatelet agent). The primary efficacy endpoint was stroke, systemic embolism, myocardial infarction, unstable angina requiring revascularisation, and all-cause mortality. The primary safety endpoint was major bleeding.

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