Dual antiplatelet therapy versus oral anticoagulation plus dual antiplatelet therapy in patients with atrial fibrillation and low-to-moderate thromboembolic risk undergoing coronary stenting: Design of the MUSICA-2 randomized trial

Antonia Sambola, J. Bruno Montoro, Bruno García Del Blanco, Nadia Llavero, José A. Barrabés, Fernando Alfonso, Héctor Bueno, Angel Cequier, Antonio Serra, Javier Zueco, Manel Sabaté, Oriol Rodríguez-Leor, David García-Dorado

Research output: Contribution to journalArticleResearchpeer-review

22 Citations (Scopus)

Abstract

Background Oral anticoagulation (OAC) is the recommended therapy for patients with atrial fibrillation (AF) because it reduces the risk of stroke and other thromboembolic events. Dual antiplatelet therapy (DAPT) is required after percutaneous coronary intervention and stenting (PCI-S). In patients with AF requiring PCI-S, the association of DAPT and OAC carries an increased risk of bleeding, whereas OAC therapy or DAPT alone may not protect against the risk of developing new ischemic or thromboembolic events. Objective The MUSICA-2 study will test the hypothesis that DAPT compared with triple therapy (TT) in patients with nonvalvular AF at low-to-moderate risk of stroke (CHADS2 score ≤2) after PCI-S reduces the risk of bleeding and is not inferior to TT for preventing thromboembolic complications. Design The MUSICA-2 is a multicenter, open-label randomized trial that will compare TT with DAPT in patients with AF and CHADS2 score ≤2 undergoing PCI-S. The primary end point is the incidence of stroke or any systemic embolism or major adverse cardiac events: death, myocardial infarction, stent thrombosis, or target vessel revascularization at 1 year of PCI-S. The secondary end point is the combination of any cardiovascular event with major or minor bleeding at 1 year of PCI-S. The calculated sample size is 304 patients. Conclusions The MUSICA-2 will attempt to determine the most effective and safe treatment in patients with nonvalvular AF and CHADS2 score ≤2 after PCI-S. Restricting TT for AF patients at high risk for stroke may reduce the incidence of bleeding without increasing the risk of thromboembolic complications. © 2013 Mosby, Inc.
Original languageEnglish
Pages (from-to)669-675
JournalAmerican Heart Journal
Volume166
Issue number4
DOIs
Publication statusPublished - 1 Oct 2013

Fingerprint Dive into the research topics of 'Dual antiplatelet therapy versus oral anticoagulation plus dual antiplatelet therapy in patients with atrial fibrillation and low-to-moderate thromboembolic risk undergoing coronary stenting: Design of the MUSICA-2 randomized trial'. Together they form a unique fingerprint.

Cite this