{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T14:56:45Z","timestamp":1763564205155,"version":"3.41.2"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"21","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,11,2]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Among patients with atrial fibrillation and stable coronary artery disease, those with histories of atherothrombotic disease are at high\u2010risk for future ischemic events. This study investigated the efficacy and safety of rivaroxaban monotherapy in patients with atrial fibrillation, coronary artery disease, and histories of atherothrombotic disease.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              This was a post hoc subanalysis of the AFIRE (Atrial Fibrillation and Ischemic Events With Rivaroxaban in Patients With Stable Coronary Artery Disease) trial. Patients with non\u2010valvular atrial fibrillation and coronary artery disease were recruited and randomized to receive the rivaroxaban monotherapy or combination therapy with rivaroxaban plus antiplatelet drug. For the purpose of this sub\u2010study, participants were divided into 2 subgroups, including the atherothrombosis group (those with histories of myocardial infarction, stroke, and\/or peripheral artery disease; n=1052, 47.5%) and non\u2010atherothrombosis group (n=1163, 52.5%). The efficacy end point included cardiovascular events or all\u2010cause death, while the safety end point was major bleeding. Net adverse events consisted of all\u2010cause death, myocardial infarction, stroke, or major bleeding. In the atherothrombosis group, rivaroxaban monotherapy was significantly associated with a lower risk of net adverse events when compared with combination therapy (hazard ratio [HR], 0.50; 95% CI, 0.34\u20130.74;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), with a decrease in both efficacy (HR, 0.68; 95% CI, 0.47\u20130.99;\n              <jats:italic>P<\/jats:italic>\n              =0.044) and safety (HR, 0.37; 95% CI, 0.19\u20130.71;\n              <jats:italic>P<\/jats:italic>\n              =0.003) end points. By contrast, there were no differences between treatment outcomes for the non\u2010atherothrombosis group.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Rivaroxaban monotherapy significantly reduced net adverse events as compared with combination therapy for patients with atrial fibrillation, coronary artery disease, and prior atherothrombotic disease.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Registration<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.umin.ac.jp\/ctr\/\">https:\/\/www.umin.ac.jp\/ctr\/<\/jats:ext-link>\n              ; Unique identifier: UMIN000016612. 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: NCT02642419.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.121.020907","type":"journal-article","created":{"date-parts":[[2021,10,18]],"date-time":"2021-10-18T11:10:00Z","timestamp":1634555400000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Antithrombotic Therapy for Atrial Fibrillation and Coronary Artery Disease in Patients With Prior Atherothrombotic Disease: A Post Hoc Analysis of the AFIRE Trial"],"prefix":"10.1161","volume":"10","author":[{"given":"Yasushi","family":"Matsuzawa","sequence":"first","affiliation":[{"name":"Division of Cardiology Yokohama City University Medical Center Yokohama 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Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2348-7646","authenticated-orcid":false,"given":"Masaharu","family":"Akao","sequence":"additional","affiliation":[{"name":"Department of Cardiology National Hospital Organization Kyoto Medical Center Kyoto Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6645-6404","authenticated-orcid":false,"given":"Junya","family":"Ako","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Kitasato University School of Medicine Sagamihara Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4563-304X","authenticated-orcid":false,"given":"Tetsuya","family":"Matoba","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Faculty of Medical Sciences Kyushu University Fukuoka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1463-3469","authenticated-orcid":false,"given":"Masato","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine Toho University Ohashi Medical Center Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katsumi","family":"Miyauchi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Juntendo Tokyo Koto Geriatric Medical Center Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nobuhisa","family":"Hagiwara","sequence":"additional","affiliation":[{"name":"Department of Cardiology Tokyo Women's Medical University Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atsushi","family":"Hirayama","sequence":"additional","affiliation":[{"name":"Department of Cardiology Osaka Police Hospital Osaka 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