Outcomes of Rivaroxaban as Part of Triple Antithrombotic Therapy in Atrial Fibrillation Patients Undergoing Percutaneous Coronary Intervention

Triple antithrombotic therapy (TAT), with dual antiplatelet and oral anticoagulant, is used in the treatment of atrial fibrillation (AF) patients undergoing percutaneous coronary intervention (PCI) TAT. This retrospective cohort single center observational study was conducted over a period of two years. Adult patients with non-valvular AF who underwent PCI and were discharged from the hospital while receiving TAT (aspirin, clopidogrel, and rivaroxahan) for one month or more were assessed. The primary endpoint was the incidence of bleeding events between patients receiving TAT for one month versus those receiving it for longer. The secondary endpoint was the incidence of death or thrombotic events in both groups. Forty-three patients were enrolled in the study; 13 patients received TAT for a short duration (SD; one month) while 30 patients received it for an extended duration (El); more than one month). The majority of patients were male 37 (86%). The primary endpoint bleeding rate was non-significantly higher in the SD group (38.5% versus 26.7%; p = 0.485). No significant differences in the secondary endpoint, thrombotic events between SD and ED (23.1% versus 6.7% respectively; p = 0.153), were observed.This study's results will be beneficial in guiding other studies seeking to determine a suitable duration for TAT using rivaroxaban to find a balance between stroke prevention and avoiding bleeding risks. Further large-scale data are needed to assess the safety and efficacy of triple antithrombotic therapy using rivaroxahan fir different durations.