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Edoxaban-based long-term antithrombotic therapy in patients with atrial fibrillation and stable coronary disease: Rationale and design of the randomized EPIC-CAD trial

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Author(s)
Min Soo ChoDo-Yoon KangYong-Seog OhChang Hoon LeeEue-Keun ChoiJi Hyun LeeChang Hee KwonGyung-Min ParkHyun Woo ParkKyoung-Ha ParkKyoung-Min ParkJongmin HwangKi-Dong YooYoung-Rak ChoYoo Ri KimKi Won HwangEun Sun JinPum-Joon KimKi Hun KimDuk-Woo ParkGi-Byoung Nam
Keimyung Author(s)
Hwang, Jong Min
Department
Dept. of Internal Medicine (내과학)
Journal Title
Am Heart J
Issued Date
2022
Volume
247
Abstract
Background:
Anticoagulants are the standard therapy for patients with atrial fibrillation (AF) and antiplatelet therapy for those with coronary artery disease (CAD). However, compelling clinical evidence is still lacking regarding the long-term maintenance strategy with the combination of anticoagulant and antiplatelet drugs in patients with AF and stable CAD.

Design:
The EPIC-CAD trial is an investigator-initiated, multicenter, open-label randomized trial comparing the safety and efficacy of 2 antithrombotic strategies in patients with high-risk AF (CHA 2 DS 2 -VASc score ≥ 2 points) and stable CAD (≥6 months after revascularization for stable angina or ≥12 months for acute coronary syndrome; or medical therapy alone). Patients (approximately N = 1,038) will be randomly assigned at a 1:1 ratio to (1) monotherapy with edoxaban (a non-vitamin K antagonist oral anticoagulant) or (2) combination therapy with edoxaban plus a single antiplatelet agent. The primary endpoint is the net composite outcome of death from any cause, stroke, systemic embolism, myocardial infarction, unplanned revascularization, and major or clinically relevant nonmajor bleeding at 1 year after randomization.

Results:
As of December 2021, approximately 901 patients had been randomly enrolled over 2 years at 18 major cardiac centers across South Korea. The completed enrollment is expected at the mid-term of 2022, and the primary results will be available by 2023.

Conclusions:
EPIC-CAD is a large-scale, multicenter, pragmatic design trial, which will provide valuable clinical insight into edoxaban-based long-term antithrombotic therapy in patients with high-risk AF and stable CAD.
Keimyung Author(s)(Kor)
황종민
Publisher
School of Medicine (의과대학)
Citation
Min Soo Cho et al. (2022). Edoxaban-based long-term antithrombotic therapy in patients with atrial fibrillation and stable coronary disease: Rationale and design of the randomized EPIC-CAD trial. Am Heart J, 247, 123–131. doi: 10.1016/j.ahj.2022.01.014
Type
Article
ISSN
0002-8703
Source
https://www.clinicalkey.com/#!/content/playContent/1-s2.0-S0002870322000230
DOI
10.1016/j.ahj.2022.01.014
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/44167
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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