Potent antiplatelet drugs increase major bleeding risk in AF patients after heart attack
Potent antiplatelet therapy increased bleeding without signs of benefit regarding cardiovascular events in patients with atrial fibrillation after a heart attack. This was the main finding of the EPIDAURUS trial presented in a Hot Line session at ESC Congress 2026 and published simultaneously in Nature Medicine.
A new study reveals that potent antiplatelet medications raise the risk of major bleeding in patients with atrial fibrillation following a heart attack. The EPIDAURUS trial, presented at ESC Congress 2026, found that when combined with direct oral anticoagulants, potent P2Y12 inhibitors prasugrel or ticagrelor significantly increased bleeding risk compared to clopidogrel-based therapy.
Atrial fibrillation affects nearly 38 million people globally and is predicted to double in prevalence over the next 35 years. In this trial, 602 out of 1,474 patients were enrolled due to safety concerns, with the experimental group experiencing a threefold higher incidence of significant bleeding (hazard ratio 3.54) than the control group within six weeks.
No difference was observed in other primary and secondary efficacy endpoints. The study concludes that these findings do not support the routine use of potent P2Y12 inhibitors alongside direct oral anticoagulants in patients with atrial fibrillation and acute coronary syndrome.
Written by urgent.news from Medical Xpress's reporting — not their text. Machine-written — may contain errors; check the original before relying on it.
