| Title: |
Reduced Rivaroxaban Dose Versus Dual Antiplatelet Therapy After Left Atrial Appendage Closure ; ADRIFT a Randomized Pilot Study |
| Authors: |
Duthoit, Guillaume; Silvain, Johanne; Marijon, Eloi; Ducrocq, Grégory; Lepillier, Antoine; Frere, Corinne; Dimby, Solohaja-Faniaha; Popovic, Batric; Lellouche, Nicolas; Martin-Toutain, Isabelle; Spaulding, Christian; Brochet, Eric; Attias, David; Mansourati, Jacques; Lorgis, Luc; Klug, Didier; Zannad, Noura; Hauguel-Moreau, Marie; Braik, Nassim; Deltour, Sandrine; Ceccaldi, Alexandre; Wang, Hui; Hammoudi, Nadjib; Brugier, Delphine; Vicaut, Eric; Juliard, Jean-Michel; Montalescot, Gilles |
| Source: |
Circulation: Cardiovascular Interventions ; volume 13, issue 7 ; ISSN 1941-7640 1941-7632 |
| Publisher Information: |
Ovid Technologies (Wolters Kluwer Health) |
| Publication Year: |
2020 |
| Description: |
Background: 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. Methods: 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 (R 10 , n=37), rivaroxaban 15 mg (R 15 , 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. Results: The primary end point was reduced with R 10 (179 pmol/L [interquartile range (IQR), 129–273], P |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1161/circinterventions.119.008481 |
| DOI: |
10.1161/CIRCINTERVENTIONS.119.008481 |
| Availability: |
https://doi.org/10.1161/circinterventions.119.008481; https://www.ahajournals.org/doi/full/10.1161/CIRCINTERVENTIONS.119.008481 |
| Accession Number: |
edsbas.B978B56E |
| Database: |
BASE |