Study on the Effects of Ticagrelor and Rivaroxaban in Patients with Atrial Fibrillation After Coronary Stent Surgery
This clinical trial is designed for patients with atrial fibrillation or atrial flutter who have recently undergone a procedure called percutaneous coronary intervention (PCI), which involves placing a stent to open blocked blood vessels in the heart. The study investigates a simplified approach to preventing blood clots using fewer medications than the current standard treatment.
Inclusion criteria: To participate in this trial, patients must be at least 18 years old and have a diagnosis of atrial fibrillation or atrial flutter, requiring treatment with direct-acting oral anticoagulants (DOACs), which are blood-thinning medications. They must have undergone a successful PCI within the past 7 days, with no additional areas requiring treatment. The procedure must have been completed without major complications such as new chest pain related to heart problems, blood clots in the stent, or new neurological symptoms. All participants must provide written informed consent, meaning they understand and agree to take part in the study.
Exclusion criteria: Patients are not eligible if they have not had a successful PCI or if they are not suitable candidates for DOAC treatment after receiving a specific type of stent called a sirolimus-eluting Supraflex Cruz stent. Additionally, those without a confirmed diagnosis of atrial fibrillation or flutter, those outside the specified age range, or those belonging to vulnerable populations requiring special protection are excluded from participation.
Focus and goal: The primary goal of this study is to compare a simplified treatment approach with the current standard care. In the new approach, patients initially take only a P2Y12 inhibitor (a medication that prevents platelets from clumping together) for one month, followed by a DOAC alone for the remainder of the 15-month study period. This is compared to the standard treatment, which involves taking three medications for up to one month (aspirin, a P2Y12 inhibitor, and a DOAC), followed by two medications for 6 to 12 months, and then a single medication. Researchers will monitor participants for major heart and brain events such as heart attacks or strokes, as well as significant bleeding complications, to determine if the simplified approach is as safe and effective as the current standard.
Investigational drugs: The trial uses two main types of medications. The first is a P2Y12 inhibitor, which is taken orally for the first month. This medication works by blocking a specific receptor on platelets, preventing them from sticking together and forming clots. The second is a Direct-Acting Oral Anticoagulant (DOAC), which is used for long-term treatment after the initial month. DOACs work by directly inhibiting specific clotting factors in the blood, helping to prevent harmful blood clots while potentially reducing the risk of bleeding compared to using multiple medications together.
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