Dual antithrombotic therapy with dabigatran after PCI in atrial fibrillation
Open accessAbstract
BACKGROUND: Triple antithrombotic therapy with warfarin plus two antiplatelet agents is the standard of care after percutaneous coronary intervention (PCI) for patients with atrial fibrillation, but this therapy is associated with a high risk of bleeding. METHODS: inhibitor (clopidogrel or ticagrelor) and no aspirin (110-mg and 150-mg dual-therapy groups). Outside the United States, elderly patients (≥80 years of age; ≥70 years of age in Japan) were randomly assigned to the 110-mg dual-therapy group or the triple-therapy group. The primary end point was a major or clinically relevant nonmajor bleeding event during follow-up (mean follow-up, 14 months). The trial also tested for the noninferiority of dual therapy with dabigatran (both doses combined) to triple therapy with warfarin with respect to the incidence of a composite efficacy end point of thromboembolic events (myocardial infarction, stroke, or systemic embolism), death, or unplanned revascularization. RESULTS: The incidence of the primary end point was 15.4% in the 110-mg dual-therapy group as compared with 26.9% in the triple-therapy group (hazard ratio, 0.52; 95% confidence interval [CI], 0.42 to 0.63; P<0.001 for noninferiority; P<0.001 for superiority) and 20.2% in the 150-mg dual-therapy group as compared with 25.7% in the corresponding triple-therapy group, which did not include elderly patients outside the United States (hazard ratio, 0.72; 95% CI, 0.58 to 0.88; P<0.001 for noninferiority). The incidence of the composite efficacy end point was 13.7% in the two dual-therapy groups combined as compared with 13.4% in the triple-therapy group (hazard ratio, 1.04; 95% CI, 0.84 to 1.29; P=0.005 for noninferiority). The rate of serious adverse events did not differ significantly among the groups. CONCLUSIONS: inhibitor, and aspirin. Dual therapy was noninferior to triple therapy with respect to the risk of thromboembolic events. (Funded by Boehringer Ingelheim; RE-DUAL PCI ClinicalTrials.gov number, NCT02164864 .).
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Cites
Dabigatran versus warfarin in patients with atrial fibrillation
Connolly, S. J., Ezekowitz, M. D., Yusuf, S., Eikelboom, J., Oldgren, J., Parekh, A., Pogue, J., Reilly, P. A., Themeles, E., Varrone, J., et al. (2009) · New England Journal of Medicine · doi:10.1056/nejmoa0905561 · Cited by 11,215 · see citing works
Rivaroxaban versus warfarin in nonvalvular atrial fibrillation
Patel, M. R., Mahaffey, K. W., Garg, J., Pan, G., Singer, D. E., Hacke, W., Breithardt, G., Halperin, J. L., Hankey, G. J., Piccini, J. P., et al. (2011) · New England Journal of Medicine · doi:10.1056/nejmoa1009638 · Cited by 9,430 · see citing works
2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS
Kirchhof, P., Benussi, S., Kotecha, D., Ahlsson, A., Atar, D., Casadei, B., Castella, M., Diener, H.-C., Heidbuchel, H., Hendriks, J., et al. (2016) · European Heart Journal · doi:10.1093/eurheartj/ehw210 · Cited by 6,418 · see citing works
Self-citationSchulman, S., & Kearon, C. (2005) · Journal of Thrombosis and Haemostasis · doi:10.1111/j.1538-7836.2005.01204.x · Cited by 5,025 · see citing works
2014 ESC/EACTS Guidelines on myocardial revascularization
Authors Task Force Members, Windecker, S., Kolh, P., Alfonso, F., Collet, J., Cremer, J., Falk, V., Filippatos, G., Hamm, C. W., Head, S. J., et al. (2014) · European Heart Journal · doi:10.1093/eurheartj/ehu278 · Cited by 4,340 · see citing works
January, C. T., Wann, L. S., Alpert, J. S., Calkins, H., Cigarroa, J. E., Cleveland, J. C., Conti, J. B., Ellinor, P. T., Ezekowitz, M. D., Field, M. E., et al. (2014) · Circulation · doi:10.1161/cir.0000000000000040 · Cited by 2,056 · see citing works
Dewilde, W. J., Oirbans, T., Verheugt, F. W., Kelder, J. C., De Smet, B. J., Herrman, J.-P., Adriaenssens, T., Vrolix, M., Heestermans, A. A., Vis, M. M., et al. (2013) · The Lancet · doi:10.1016/s0140-6736(12)62177-1 · Cited by 1,719 · see citing works
Prevention of bleeding in patients with atrial fibrillation undergoing PCI
Gibson, C. M., Mehran, R., Bode, C., Halperin, J., Verheugt, F. W., Wildgoose, P., Birmingham, M., Ianus, J., Burton, P., van Eickels, M., et al. (2016) · New England Journal of Medicine · doi:10.1056/nejmoa1611594 · Cited by 1,590 · see citing works
Self-citationLevine, G. N., Bates, E. R., Bittl, J. A., Brindis, R. G., Fihn, S. D., Fleisher, L. A., Granger, C. B., Lange, R. A., Mack, M. J., Mauri, L., et al. (2016) · Circulation · doi:10.1161/cir.0000000000000404 · Cited by 1,355 · see citing works
2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention: Executive Summary
Levine, G. N., Bates, E., Blankenship, J. C., Bailey, S. R., Bittl, J. A., Cercek, B., Chambers, C. E., Ellis, S. G., Guyton, R. A., Hollenberg, S. M., et al. (2011) · Circulation · doi:10.1161/cir.0b013e31823a5596 · Cited by 631 · see citing works
Self-citationTask Force Members, Lip, G. Y. H., Windecker, S., Huber, K., Kirchhof, P. F., Marín, F. R., ten Berg, J. M., Hæusler, K. G., Boriani, G., Capodanno, D., et al. (2014) · European Heart Journal · doi:10.1093/eurheartj/ehu298 · Cited by 567 · see citing works
Self-citationDans, A. L., Connolly, S. J., Wallentin, L., Yang, S., Nakamya, J., Brueckmann, M., Ezekowitz, M., Oldgren, J., Eikelboom, J. W., Reilly, P. A., et al. (2013) · Circulation · doi:10.1161/circulationaha.112.115386 · Cited by 484 · see citing works
Self-citationFiedler, K. A., Maeng, M., Mehilli, J., Schulz-Schüpke, S., Byrne, R., Sibbing, D., Hoppmann, P., Schneider, S., Fusaro, M., Ott, I., et al. (2015) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2015.02.050 · Cited by 454 · see citing works
Self-citationLamberts, M., Olesen, J. B., Ruwald, M. H., Hansen, C. M., Karasoy, D., Kristensen, S. L., Køber, L., Torp-Pedersen, C., Gislason, G. H., & Hansen, M. L. (2012) · Circulation · doi:10.1161/circulationaha.112.114967 · Cited by 413 · see citing works
Vitamin K antagonists in heart disease: Current status and perspectives (Section III)
Husted, S., Wallentin, L. C., Andreotti, F., Arnesen, H., Bachmann, F., Baigent, C., Huber, K., Jespersen, J., Kristensen, S. D., Lip, G. Y. H., et al. (2013) · Thrombosis and Haemostasis · doi:10.1160/th13-06-0443 · Cited by 367 · see citing works
Self-citationParenteral anticoagulants in heart disease: Current status and perspectives (Section II)
Husted, S., Wallentin, L. C., Andreotti, F., Arnesen, H., Bachmann, F., Baigent, C., Huber, K., Jespersen, J., Kristensen, S. D., Lip, G. Y. H., et al. (2013) · Thrombosis and Haemostasis · doi:10.1160/th12-06-0403 · Cited by 366 · see citing works
Self-citationLamberts, M., Gislason, G., Olesen, J., Kristensen, S., Olsen, A. S., Mikkelsen, A., Christensen, C. B., Lip, G., Køber, L., Torp-Pedersen, C., et al. (2013) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2013.05.029 · Cited by 350 · see citing works
Self-citationEikelboom, J. W., Berger, P. B., Holmes, D. R., Bhatt, D. L., Becker, R. C., Angiolill, D., Faxon, D. P., & Moliterno, D. J. (2011) · Thrombosis and Haemostasis · doi:10.1160/th11-04-0262 · Cited by 204 · see citing works
Self-citationGibson, C. M., Pinto, D. S., Chi, G., Arbetter, D. F., Yee, M., Mehran, R., Bode, C., Halperin, J. L., Verheugt, F. W. A., Wildgoose, P., et al. (2016) · Circulation · doi:10.1161/circulationaha.116.025783 · Cited by 95 · see citing works
Self-citationAngiolillo, D. J., Goodman, S. G., Bhatt, D. L., Eikelboom, J. W., Price, M. J., Moliterno, D. J., Cannon, C. P., Tanguay, J., Granger, C. B., Mauri, L., et al. (2016) · Circulation Cardiovascular Interventions · doi:10.1161/circinterventions.116.004395 · Cited by 90 · see citing works
Self-citationCannon, C. P., Gropper, S., Bhatt, D. L., Ellis, S. G., Kimura, T., Lip, G. Y. H., Steg, P. G., ten Berg, J. M., Manassie, J., Kreuzer, J., et al. (2016) · Clinical Cardiology · doi:10.1002/clc.22572 · Cited by 72 · see citing works
Self-citationAndrade, J. G., Deyell, M. W., Khoo, C., Lee, M., Humphries, K. H., & Cairns, J. A. (2012) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2012.06.012 · Cited by 63 · see citing works
Triple Therapy for Atrial Fibrillation and Percutaneous Coronary Intervention
Dewilde, W. J. M., Janssen, P. W. A., Verheugt, F. W. A., Storey, R. F., Adriaenssens, T., Hansen, M. L., Lamberts, M., & ten Berg, J. M. (2014) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2014.06.1193 · Cited by 51 · see citing works
Depta, J. P., Cannon, C. P., Fonarow, G. C., Zhao, X., Peacock, W. F., & Bhatt, D. L. (2009) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2009.06.027 · Cited by 26 · see citing works
Self-citationBhatt, D. L. (2016) · Circulation · doi:10.1161/circulationaha.116.025923 · Cited by 26 · see citing works
Self-citationSteg, P. G., & Bhatt, D. L. (2015) · European Heart Journal Acute Cardiovascular Care · doi:10.1177/2048872615610868 · Cited by 24 · see citing works
Self-citationJACKSON, K. P., Gersh, B. J., Stockbridge, N., Fleming, T. R., Temple, R., Califf, R. M., Connolly, S. J., Wallentin, L. C., & Granger, C. B. (2008) · American Heart Journal · doi:10.1016/j.ahj.2008.01.023 · Cited by 21 · see citing works
Vardi, M., Debidda, M., Bhatt, D. L., Mauri, L., & Cannon, C. P. (2013) · Clinical Cardiology · doi:10.1002/clc.22226 · Cited by 13 · see citing works
Self-citation
Flagged first, then by citations
Research works printed but not linked: 2
- Bhatt DL. O PIONEERs! The beginning of the end of full-dose triple therapy with warfarin? Circulation 2017; 135: 334-7.
- Rosendaal FR, Cannegieter SC, van der Meer FJM, Briët E. A method to determine the optimal intensity of oral anticoagu- lant therapy. Thromb Haemost 1993; 3: 236-9.
Cited by
Sorted by citations
2018 ESC/EACTS guidelines on myocardial revascularization
Neumann, F.-J., Sousa-Uva, M., Ahlsson, A., Alfonso, F., Banning, A. P., Benedetto, U., Byrne, R. A., Collet, J.-P., Falk, V., Head, S. J., et al. (2019) · European Heart Journal · doi:10.1093/eurheartj/ehy394 · Cited by 7,167 · see citing works
2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes
Knuuti, J., Wijns, W., Saraste, A., Capodanno, D., Barbato, E., Funck-Brentano, C., Prescott, E., Storey, R. F., Deaton, C., Cuisset, T., et al. (2020) · European Heart Journal · doi:10.1093/eurheartj/ehz425 · Cited by 7,166 · see citing works
Self-citationCollet, J.-P., Thiele, H., Barbato, E., Barthélémy, O., Bauersachs, J., Bhatt, D. L., Dendale, P., Dorobantu, M., Edvardsen, T., Folliguet, T., et al. (2021) · European Heart Journal · doi:10.1093/eurheartj/ehaa575 · Cited by 5,037 · see citing works
Self-citationJanuary, C. T., Wann, L. S., Calkins, H., Chen, L. Y., Cigarroa, J. E., Cleveland, J. C., Ellinor, P. T., Ezekowitz, M. D., Field, M. E., Furie, K. L., et al. (2019) · Circulation · doi:10.1161/cir.0000000000000665 · Cited by 2,744 · see citing works
2023 ESC guidelines for the management of cardiovascular disease in patients with diabetes.
Marx, N., Federici, M., Schütt, K., Müller-Wieland, D., Ajjan, R. A., Antunes, M. J., Christodorescu, R. M., Crawford, C., Di Angelantonio, E., Eliasson, B., et al. (2023) · European Heart Journal · doi:10.1093/eurheartj/ehad192 · Cited by 1,642 · see citing works
Antithrombotic therapy after acute coronary syndrome or PCI in atrial fibrillation
Lopes, R. D., Heizer, G., Aronson, R., Vora, A. N., Massaro, T., Mehran, R., Goodman, S. G., Windecker, S., Darius, H., Li, J., et al. (2019) · New England Journal of Medicine · doi:10.1056/nejmoa1817083 · Cited by 1,228 · see citing works
Steffel, J., Collins, R., Antz, M., Cornu, P., Desteghe, L., Haeusler, K. G., Oldgren, J., Reinecke, H., Roldan-Schilling, V., Rowell, N., et al. (2021) · EP Europace · doi:10.1093/europace/euab065 · Cited by 1,132 · see citing works
Self-citation2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation
Joglar, J. A., Chung, M. K., Armbruster, A. L., Benjamin, E. J., Chyou, J. Y., Cronin, E. M., Deswal, A., Eckhardt, L. L., Goldberger, Z. D., Gopinathannair, R., et al. (2024) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2023.08.017 · Cited by 933 · see citing works
Rao, S. V., O’Donoghue, M. L., Ruel, M., Rab, T., Tamis-Holland, J. E., Alexander, J. H., Baber, U., Baker, H., Cohen, M. G., Cruz-Ruiz, M., et al. (2025) · Circulation · doi:10.1161/cir.0000000000001309 · Cited by 625 · see citing works
Potpara, T. S., Mujovic, N., Proietti, M., Dagres, N., Hindricks, G., Collet, J.-P., Valgimigli, M., Heidbuchel, H., & Lip, G. Y. H. (2020) · EP Europace · doi:10.1093/europace/euz259 · Cited by 98 · see citing works
Self-citationAntithrombotic Therapy for Peripheral Artery Disease
Hussain, M. A., Al-Omran, M., Creager, M. A., Anand, S. S., Verma, S., & Bhatt, D. L. (2018) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2018.03.483 · Cited by 69 · see citing works
Self-citationKumbhani, D. J., Armbruster, A. L., Cheng, R. K., Chrispin, J., Fischer, U., Holbrook, A. M., Joglar, J., & Sevestre, M.-A. (2026) · JACC · doi:10.1016/j.jacc.2026.05.033 · Cited by 2 · see citing works
- Authors
- Cannon, C. P., Bhatt, D. L., Oldgren, J., Lip, G. Y. H., Ellis, S. G., Kimura, T., Maeng, M., Merkely, B., Zeymer, U., Gropper, S., Nordaby, M., Kleine, E., Harper, R., Manassie, J., Januzzi, J. L., ten Berg, J. M., Steg, P. G., & Hohnloser, S. H.
- Affiliations
- Uppsala University (SE)
- From the Baim Institute for Clinical Research (C.P.C., J.L.J.), Brigham and Women’s Hospital, Heart and Vascular Center, and Harvard Medical School (C.P.C., D.L.B.), and the Cardiology Division, Massachusetts General Hospital, and Harvard Medical School (J.L.J.) — all in Boston; Uppsala Clinical Research Center and Department of Medical Sciences, Uppsala University, Uppsala, Sweden (J.O.); the Institute of Cardiovascular Sciences, University of Birmingham, Birmingham (G.Y.H.L.), Boehringer Ingelheim,...
- Goethe University Frankfurt (DE)
- ORCID
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2017-10-19
- Volume
- 377
- Issue
- 16
- Pages
- 1513-1524
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2749929702
- Cited by
- 1,383
- References
- 28
- Citations by year
- 2026: 71 · 2025: 69 · 2024: 80 · 2023: 99 · 2022: 136 · 2021: 185 · 2020: 252 · 2019: 248 · 2018: 201 · 2017: 38 · 2016: 1
- FWCI
- 156.18
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- SZTE Publicatio Repozitórium (University of Szeged) (acceptedVersion, other-oa)
- KTH Publication Database DiVA (KTH Royal Institute of Technology) (submittedVersion, other-oa)
- VUBIR (Vrije Universiteit Brussel) (submittedVersion)
- Funders
- Amgen
- Bristol-Myers Squibb
- Eli Lilly and Company
- Pfizer
- AstraZeneca
- Sanofi
- Alnylam Pharmaceuticals
- CSL Behring
- Boston Scientific Corporation
- Regeneron Pharmaceuticals
- Ironwood Pharmaceuticals, Incorporated
- Amarin Corporation
- Medicines Company
- Kowa Company
- Singulex
- Regado Biosciences
- Belvoir Media Group
- Bayer HealthCare
- ZonMw
- Eisai
- Servier
- Daiichi Sankyo Europe
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Antiplatelet Therapy and Cardiovascular Diseases
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Surgery › Coronary Interventions and Diagnostics
- Keywords
- dual antithrombotic therapy, triple antithrombotic therapy, percutaneous coronary intervention, atrial fibrillation, antiplatelet therapy, clopidogrel, ticagrelor, warfarin, bleeding risk, non-inferiority, thromboembolic events, elderly patients, direct oral anticoagulants
- MeSH terms
- Dabigatran, Clopidogrel, Ticagrelor, Adenosine, Aged, Anticoagulants, Aspirin, Atrial Fibrillation, Drug Therapy, Combination, Female, Hemorrhage, Humans, Male, Middle Aged, Platelet Aggregation Inhibitors, Risk, Ticlopidine, Warfarin, Incidence, Purinergic P2Y Receptor Antagonists, Percutaneous Coronary Intervention
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