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Rivaroxaban in Patients With Atrial Fibrillation and Coronary Artery Disease Undergoing Percutaneous Coronary Intervention

Registration Number
NCT02334254
Lead Sponsor
Beijing Anzhen Hospital
Brief Summary

To evaluate the safety for the combination of Rivaroxaban and Ticagrel versus triple antithrombotic regimen (Vitamin K Antagonist (VKA), Clopigogrel and Aspirin) in patients with atrial fibrillation and coronary artery disease undergoing percutaneous coronary intervention (PCI).

Detailed Description

This is an open-label (both physician and participant know the treatment that the participant receives), randomized (study medication is assigned by chance), multicenter clinical study assessing the safety of the combination of rivaroxaban and ticagrel versus triple antithrombotic regimen (warfarin, clopigogrel and aspirin) in patients, who have paroxysmal, persistent, or permanent non-valvular atrial fibrillation (AF) and concomitant coronary artery disease undergoing percutaneous coronary intervention (PCI). A target of 420 participants will be randomized into the study, with approximately 210 participants in each treatment strategy group. Primary comparisons will be made of the rates of major and clinically relevant bleeding, assessed by the modified International Society of Thrombosis and Haemostasis (ISTH) classification. The study consists of a screening phase, a 12-month open-label treatment phase, and an end-of-treatment/early withdrawal visit. The total duration of participation in the study for each participant is approximately 12 months.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
420
Inclusion Criteria
  • a long-term indication for oral anticoagulation treatment (until at least 1 year after the study)
  • a severe coronary lesion (at least 75% stenosis on angiography or fractional flow reserve lower than 0•80) with indication for PCI
  • age 18-80 years
Exclusion Criteria
  • history of intracranial bleeding;
  • cardiogenic shock;
  • contra indication to use of antiplatelet or anticoagulation drugs;
  • peptic ulcer in the previous 6 months;
  • thrombo cytopenia (platelet concentration lower than 50~10⁹/L);
  • major bleeding (according to the Thrombolysis in Myocardial Infarction [TIMI] criteria) in the past 12 months; and
  • pregnancy.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Dual antithrombotic therapy (DAT)rivaroxaban and ticagrel therapyDual Antithrombotic Therapy (DAT) regimen of rivaroxaban 2.5mg/5mg b.i.d. plus ticagrelor 90mg b.i.d.
Triple antithrombotic therapy (TAT)triple antithrombotic regimen with warfarin, asipirin and clopidogrelTriple antithrombotic therapy (TAT) regimen of aspirin 100mg q.d., clopidogrel 75mg q.d. plus warfarin (INR 1.8-2.5).
Primary Outcome Measures
NameTimeMethod
Major or clinically relevant non-major bleeding12 months

Major bleeding was assessed by the International Society of Thrombosis and Hemostasis (ISTH) definition. It included bleeding that was fatal, occurred in a critical location (intracranial, intraspinal, intraocular, retroperitoneal, intraarticular, intramuscular with compartment syndrome, or pericardial), or was associated with a fall in hemoglobin of 2 g/dL or a transfusion of 2 units of packed red blood cells. Clinically relevant non-major bleeding was defined as bleeding that required medical or surgical intervention.

Secondary Outcome Measures
NameTimeMethod
Composite outcome of death, myocardial infarction, stent thrombosis and ischemic stroke12 months

Trial Locations

Locations (1)

Beijing Anzhen Hospital,Capital Medical University

🇨🇳

Beijing, Beijing, China

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