A 12 lead ECG displaying atrial fibrillation at roughly 150 beats per minute. Credit score: James Heilman, MD/Wikipedia/CC BY-SA 3.0
New analysis discovered a simplified clot-preventing treatment routine following stent placement in adults with atrial fibrillation was simply as secure and efficient in stopping strokes, coronary heart assault and loss of life, when in comparison with an ordinary year-long remedy routine, in line with a preliminary late-breaking science presentation Saturday on the American Coronary heart Affiliation’s Scientific Periods 2025. The assembly, held Nov. 7–10 in New Orleans, is a premier world alternate of the newest scientific developments, analysis and evidence-based medical follow updates in cardiovascular science.
This examine included adults with atrial fibrillation (AFib), a standard coronary heart rhythm dysfunction, who acquired a stent in a coronary heart artery to enhance blood circulation. Normal remedy after a stent implantation is a prescription for 2 clot-preventing drugs for one yr, nevertheless, these drugs may also enhance the danger of great bleeding, defined examine creator Yohei Sotomi, M.D., Ph.D., director of the Osaka Cardiovascular Convention Multicenter Scientific Analysis Lab within the Division of Cardiovascular Medication at College of Osaka Graduate College of Medication in Osaka, Japan.
The 2 drugs included a direct oral anticoagulant, reminiscent of dabigatran, rivaroxaban, apixaban and edoxaban to assist forestall strokes; and a P2Y12 inhibitor, reminiscent of clopidogrel or prasugrel, to forestall clots within the stent.
On this examine, the OPTIMA-AF trial, researchers explored if utilizing each drugs for one month amongst individuals with AFib who acquired a stent can be equally secure and efficient as 12 months of remedy, whereas serving to to scale back bleeding danger related to the drugs.
“Previous studies confirmed that using two anti-clotting agents instead of three reduced bleeding, however, no study has tested whether the duration of dual therapy could be safely shortened to just one month,” Sotomi mentioned. “Our study is the first to show that a one-month strategy is both safe and effective, offering real-world benefits for patients and doctors.”
Researchers studied greater than 1,000 adults in Japan who had AFib and acquired a stent in a coronary heart artery. After the stent placement process, half of the examine members have been prescribed each varieties of drugs for one month, then solely the direct oral anticoagulant for the remaining 11 months. The opposite half of members continued twin remedy for 12 months.
Members have been adopted for one yr to observe if that they had a stroke, coronary heart assault or died. Researchers additionally analyzed what number of members had bleeding issues reminiscent of gastrointestinal bleeding.
The evaluation discovered:
5.4% of members within the one-month group and 4.5% within the 12-month group had a coronary heart assault, stroke or died, which researchers mentioned suggests the shorter method was equally efficient.
Members within the one-month dual-treatment group had notably fewer bleeding issues: 4.8% versus 9.5% within the 12-month group.
A lot of the bleeding discount got here from much less critical bleeds that required medical consideration, which impacts high quality of life and might enhance well being care prices for emergency or clinic visits, lab and imaging assessments.
“These results may help doctors feel more confident in prescribing shorter durations of dual antithrombotic therapy after stenting among some patients with AFib,” Sotomi mentioned. “By reducing the length of time individuals are exposed to combination therapy, we can lower the risk of bleeding—a serious concern for many older adults—without increasing their risk of stroke or heart attack.”
As much as 1 in 10 individuals who obtain a stent even have AFib, a dysfunction that will increase stroke danger by five-fold and might result in blood clots, coronary heart failure and loss of life, Sotomi mentioned. In keeping with the American Coronary heart Affiliation 2025 Coronary heart and Stroke statistics, an estimated 5 million adults within the U.S. have AFib, and it’s predicted that greater than 12 million individuals within the U.S. can have it by 2030.
The examine was carried out in Japan, so its findings could in a roundabout way apply to individuals in different international locations. One other limitation is that examine members principally had secure coronary heart illness, so outcomes could not apply to sufferers with larger danger for blood clots. As well as, solely about 20% of the examine inhabitants have been girls, so generalizability to girls is proscribed.
Research particulars, background and design:
The examine included 1,101 adults with a median age of 75.2 years previous; 79% have been males; and all had atrial fibrillation and underwent a process to implant a drug-eluting stent.
The examine enrolled members with AFib who acquired stents at 75 hospitals in Japan between October 2019 and September 2024.
Researchers collected information on charges of loss of life, stroke, coronary heart assault, clotting in stents and bleeding occasions.
The trial in contrast one-month versus 12-month twin antithrombotic remedy with a direct oral anticoagulant and a P2Y12 inhibitor, adopted by the oral anticoagulant alone, with outcomes assessed at 12 months.
Members and researchers knew which routine every participant acquired; nevertheless, project to the regimens was by probability.
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One month of clot prevention after a stent was as efficient as year-long course for AFib (2025, November 10)
retrieved 10 November 2025
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