One-month Dual Therapy Strategy Offers Advantages For Afib Patients And Clinicians

New investigation recovered a simplified clot-preventing medicine regimen pursuing stent placement successful adults pinch atrial fibrillation was conscionable arsenic safe and effective successful preventing strokes, bosom onslaught and death, erstwhile compared to a modular year-long curen regimen, according to a preliminary late-breaking subject position coming astatine nan American Heart Association's Scientific Sessions 2025.

The meeting, Nov. 7-10, successful New Orleans, is simply a premier world speech of nan latest technological advancements, investigation and evidence-based objective believe updates successful cardiovascular science.

This study included adults with atrial fibrillation (AFib), a communal bosom hit disorder, who received a stent in a bosom artery to amended humor flow. Standard curen aft a stent implantation is simply a medicine for 2 clot-preventing medications for 1 year, however, these medications tin besides summation nan consequence of superior bleeding, explained study writer Yohei Sotomi, M.D., Ph.D., head of nan Osaka Cardiovascular Conference Multicenter Clinical Research Lab successful nan Department of Cardiovascular Medicine astatine University of Osaka Graduate School of Medicine successful Osaka, Japan. The 2 medications included a nonstop oral anticoagulant, specified arsenic dabigatran, rivaroxaban, apixaban and edoxaban to thief forestall strokes; and a P2Y12 inhibitor, specified arsenic clopidogrel aliases prasugrel, to forestall clots successful nan stent.

In this study, nan OPTIMA-AF trial, researchers explored if utilizing some medications for 1 period among group pinch AFib who received a stent would beryllium arsenic safe and effective arsenic 12 months of treatment, while helping to trim bleeding consequence associated pinch nan medications.

"Previous studies confirmed that utilizing 2 anti-clotting agents alternatively of 3 reduced bleeding, however, nary study has tested whether nan long of dual therapy could beryllium safely shortened to conscionable 1 month," Sotomi said.

Our study is nan first to show that a one-month strategy is some safe and effective, offering real-world benefits for patients and doctors."

Yohei Sotomi, University of Osaka Graduate School of Medicine

Researchers studied much than 1,000 adults successful Japan who had AFib and received a stent successful a bosom artery. After nan stent placement procedure, half of nan study participants were prescribed some types of medications for 1 month, past only nan nonstop oral anticoagulant for nan remaining 11 months. The different half of participants continued dual therapy for 12 months.

Participants were followed for 1 twelvemonth to show if they had a stroke, bosom onslaught aliases died. Researchers besides analyzed really galore participants had bleeding complications specified arsenic gastrointestinal bleeding.

The study found:

• 5.4% of participants successful nan one-month group and 4.5% successful nan 12-month group had a bosom attack, changeable aliases died, which researchers said suggests nan shorter attack was arsenic effective.
• Participants successful nan one-month dual-treatment group had notably less bleeding complications: 4.8% versus 9.5% successful nan 12-month group.
• Most of nan bleeding simplification came from little superior bleeds that required aesculapian attention, which affects value of life and tin summation wellness attraction costs for emergency aliases session visits, laboratory and imaging tests.

"These results whitethorn thief doctors consciousness much assured successful prescribing shorter durations of dual antithrombotic therapy aft stenting among immoderate patients pinch AFib," Sotomi said. "By reducing nan magnitude of clip individuals are exposed to operation therapy, we tin little nan consequence of bleeding - a superior interest for galore older adults-without expanding their consequence of changeable aliases bosom attack."

Up to 1 successful 10 group who person a stent besides person AFib, a upset that increases changeable consequence by five-fold and tin lead to humor clots, bosom nonaccomplishment and death, Sotomi said. According to the American Heart Association 2025 Heart and Stroke statistics, an estimated 5 cardinal adults successful nan U.S. person AFib, and it is predicted that much than 12 cardinal group successful nan U.S. will person it by 2030.

The study was conducted successful Japan, truthful its findings whitethorn not straight use to group successful different countries. Another limitation is that study participants mostly had unchangeable bosom disease, truthful results whitethorn not use to patients pinch higher consequence for humor clots. In addition, only astir 20% of nan study organization were women, truthful generalizability to women is limited.

Study details, inheritance and design:

• The study included 1,101 adults pinch an mean property of 75.2 years old; 79% were men; and each had atrial fibrillation and underwent a process to implant a drug-eluting stent.
• The study enrolled participants pinch AFib who received stents astatine 75 hospitals successful Japan betwixt October 2019 and September 2024.
• Researchers collected information connected rates of death, stroke, bosom attack, clotting successful stents and bleeding events.
• The proceedings compared one-month versus 12-month dual antithrombotic therapy pinch a nonstop oral anticoagulant and a P2Y12 inhibitor, followed by nan oral anticoagulant alone, pinch outcomes assessed astatine 12 months.
• Participants and researchers knew which regimen each subordinate received; however, duty to nan regimens was by chance.