December 22, 2016
3 min watch

VIDEO: PIONEER AF-PCI results may provide 'safer way to treat patients'

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NEW ORLEANS – In this video, Joseph B. Muhlestein, MD, co-director of cardiology research at Intermountain Medical Center in Murray, Utah, discusses the PIONEER trial.

Muhlestein calls the trial “a seminal study” that examined how best to manage patients with atrial fibrillation and coronary disease in whom a coronary stent was recently implanted. He reviews the therapeutic options for these patients, including warfarin, anticoagulants and dual antiplatelet therapy, while noting that, when given together, there is “a significant risk of bleeding.” The PIONEER trial examined which of these agents – in combination or alone – are the safest and most effective and demonstrated that there was “no significant difference” in efficacy between the different combinations.

“Consequently, we have fairly good evidence to support that the use of a low-dose, direct oral anticoagulant like rivaroxaban in conjunction with either P2Y12 inhibition alone or the combination of aspirin plus P2Y12 inhibition is safer and probably as effective,” Muhlestein said.