{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T00:45:24Z","timestamp":1790383524508,"version":"4.1.0"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Interventions"],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Among atrial fibrillation patients undergoing percutaneous coronary intervention enrolled in PIONEER AF-PCI (An Open-Label, Randomized, Controlled, Multicenter Study Exploring Two Treatment Strategies of Rivaroxaban and a Dose-Adjusted Oral Vitamin K Antagonist Treatment Strategy in Subjects With Atrial Fibrillation Who Undergo Percutaneous Coronary Intervention), it is unclear if the observed reduction in bleeding events with rivaroxaban regimens is consistent across a range of the international normalized ratio (INR) among subjects administrated Vitamin K antagonist (VKA)-triple therapy. This analysis compares the occurrence of clinically significant bleeding between rivaroxaban and VKA strategies, according to INR stability of subjects administrated VKA.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results:<\/jats:title>\n            <jats:p>\n              A total of 2124 atrial fibrillation patients undergoing percutaneous coronary intervention were randomized to 3 groups: rivaroxaban 15 mg od plus a P2Y\n              <jats:sub>12<\/jats:sub>\n              inhibitor (group 1, n=709); rivaroxaban 2.5 mg bid plus dual antiplatelet therapy (group 2, n=709); and warfarin plus dual antiplatelet therapy (group 3, n=706). Subjects assigned to the VKA group were stratified according to time in therapeutic range and time spent with an INR &gt;3. Kaplan-Meier estimates were calculated for clinically significant bleeding through 1 year and hazard ratios were derived using Cox Proportional Hazards models. Among group 3, 93.4% of the participants had a time in therapeutic range available (mean time in therapeutic range=65.0\u00b124.8%). Both groups 1 and 2 were associated with a reduction in clinically significant bleeding compared with subjects in group 3, regardless of the time in therapeutic range (hazard ratio ranges=0.53\u20130.71 and 0.57\u20130.76; respectively,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.05 for all). Rivaroxaban strategies were associated with a reduction in clinically significant bleeding compared with VKA regardless of the proportion of time spent with an INR &gt;3 (hazard ratio ranges=0.59\u20130.67 and 0.42\u20130.69;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.05 for all).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Among atrial fibrillation patients undergoing percutaneous coronary intervention, rivaroxaban-based therapy was superior to warfarin plus dual antiplatelet therapy in lowering bleeding outcomes regardless of the INR stability.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Clinical Trial Registration:<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              . Unique identifier: NCT01830543.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circinterventions.118.007124","type":"journal-article","created":{"date-parts":[[2019,2,1]],"date-time":"2019-02-01T10:07:12Z","timestamp":1549015632000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Association of International Normalized Ratio Stability and Bleeding Outcomes Among Atrial Fibrillation Patients Undergoing Percutaneous Coronary Intervention"],"prefix":"10.1161","volume":"12","author":[{"given":"Mathieu","family":"Kerneis","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (M.K., M.K.Y., T.N., C.M.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan K.","family":"Yee","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (M.K., M.K.Y., T.N., C.M.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roxana","family":"Mehran","sequence":"additional","affiliation":[{"name":"Cardiovascular Institute, Mount Sinai Medical Center, Icahn School of Medicine at Mount Sinai, New York, NY (R.M., J.L.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarek","family":"Nafee","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (M.K., M.K.Y., T.N., C.M.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Bode","sequence":"additional","affiliation":[{"name":"Heart Center, Department for Cardiology and Angiology I, University of Freiburg, Germany (C.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan L.","family":"Halperin","sequence":"additional","affiliation":[{"name":"Cardiovascular Institute, Mount Sinai Medical Center, Icahn School of Medicine at Mount Sinai, New York, NY (R.M., J.L.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric D.","family":"Peterson","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Durham, NC (E.D.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Freek W.A.","family":"Verheugt","sequence":"additional","affiliation":[{"name":"Onze Lieve Vrouwe Gasthuis (OLVG), Amsterdam, the Netherlands (F.W.A.V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Wildgoose","sequence":"additional","affiliation":[{"name":"Janssen Pharmaceuticals, Inc, Beerse, Belgium, Inc, Titusville, NJ (P.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"van Eickels","sequence":"additional","affiliation":[{"name":"Bayer Pharmaceuticals, Inc, Berlin, Germany (M.v.E.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory Y.H.","family":"Lip","sequence":"additional","affiliation":[{"name":"Institute of Cardiovascular Sciences, University of Birmingham, United Kingdom (G.Y.H.L.)."},{"name":"Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Denmark (G.Y.H.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Cohen","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Newark Beth Israel Medical Center, NJ (M.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith A.A.","family":"Fox","sequence":"additional","affiliation":[{"name":"Centre for Cardiovascular Science, University of Edinburgh and Royal Infirmary of Edinburgh, United Kingdom (K.A.A.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. Michael","family":"Gibson","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA (M.K., M.K.Y., T.N., C.M.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1611594"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.110.957738"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2015.03.017"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jjcc.2015.10.019"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehx419"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2014.12.006"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.009449"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.10-0134"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0038-1651587"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1708454"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.113.000521"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.112.142158"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1186\/1477-9560-12-14"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)61751-7"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.116.026854"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12959-016-0088-y"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.118.034722"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.2217\/fca.14.13"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.112.000067"}],"container-title":["Circulation: Cardiovascular Interventions"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCINTERVENTIONS.118.007124","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T02:36:26Z","timestamp":1715567786000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCINTERVENTIONS.118.007124"}},"subtitle":["Insights From the PIONEER AF-PCI Trial"],"short-title":[],"issued":{"date-parts":[[2019,2]]},"references-count":19,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2019,2]]}},"alternative-id":["10.1161\/CIRCINTERVENTIONS.118.007124"],"URL":"https:\/\/doi.org\/10.1161\/circinterventions.118.007124","relation":{},"ISSN":["1941-7640","1941-7632"],"issn-type":[{"value":"1941-7640","type":"print"},{"value":"1941-7632","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,2]]},"assertion":[{"value":"2018-06-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-12-11","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-02-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e007124"}}