Reduced Rivaroxaban Dose Versus Dual Antiplatelet Therapy After Left Atrial Appendage Closure: ADRIFT a Randomized Pilot Study.

Circulation. Cardiovascular Interventions
Guillaume DuthoitGilles Montalescot

Abstract

Percutaneous left atrial appendage closure (LAAC) exposes to the risk of device thrombosis in patients with atrial fibrillation who frequently have a contraindication to full anticoagulation. Thereby, dual antiplatelet therapy (DAPT) is usually preferred. No randomized study has evaluated nonvitamin K antagonist oral anticoagulant after LAAC, and we decided to evaluate the efficacy and safety of reduced doses of rivaroxaban after LAAC. ADRIFT (Assessment of Dual Antiplatelet Therapy Versus Rivaroxaban in Atrial Fibrillation Patients Treated With Left Atrial Appendage Closure) is a multicenter, phase IIb study, which randomized 105 patients after successful LAAC to either rivaroxaban 10 mg (R10, n=37), rivaroxaban 15 mg (R15, n=35), or DAPT with aspirin 75 mg and clopidogrel 75 mg (n=33). The primary end point was thrombin generation (prothrombin fragments 1+2) measured 2 to 4 hours after drug intake, 10 days after treatment initiation. Thrombin-antithrombin complex, D-dimers, rivaroxaban concentrations were also measured at 10 days and 3 months. Clinical end points were evaluated at 3-month follow-up. The primary end point was reduced with R10 (179 pmol/L [interquartile range (IQR), 129-273], P<0.0001) and R15 (163 pmol/L [IQR,...Continue Reading

References

May 20, 1999·Journal of the American College of Cardiology·Y H LiJ H Chen
Jul 5, 2003·Blood·Diego ArdissinoPier Mannuccio Mannucci
Oct 4, 2005·Clinical Pharmacology and Therapeutics·Dagmar KubitzaGeorg Wensing
Jun 2, 2011·Platelets·Marek KozinskiJacek Kubica
Jun 16, 2016·Stroke; a Journal of Cerebral Circulation·Rafal MeusAnetta Undas
Aug 15, 2017·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Paul GuedeneyGilles Montalescot
Sep 10, 2017·British Journal of Clinical Pharmacology·Shigeo HorinakaToshihiko Ishimitsu
Apr 7, 2018·Journal of the American College of Cardiology·Laurent FauchierPascal Defaye
May 13, 2018·Circulation·Srinivas R DukkipatiVivek Y Reddy
Aug 26, 2018·American Journal of Cardiovascular Drugs : Drugs, Devices, and Other Interventions·Johanne SilvainUNKNOWN ATOLL Investigators

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