Participants highlight the trial’s demonstration that rivaroxaban monotherapy is noninferior in efficacy while being superior in safety, using phrases like 'confidence to use a DOAC alone' and 'practice changing'. The tone is professional and analytical, supported by references to trial details, webinars, and clinical implications, illustrating strong consensus and interest in adopting these findings in practice.
AgreementStrong agreement
Most discussions emphasize the positive findings of the trial, supporting the idea that rivaroxaban monotherapy is effective and safer, indicating strong consensus.
InterestHigh interest
The broad participation, with references to multiple analyses, webinars, and expert opinions, reflects high engagement and curiosity among professionals.
EngagementHigh engagement
Many posts reference detailed trial outcomes, safety benefits, and clinical implications, showing deep engagement and analysis.
ImpactHigh impact
The discussions focus on how this trial could influence clinical practice, such as reducing bleeding risks and simplifying therapy, demonstrating high real-world impact.
Abstract in brief
The study compared rivaroxaban monotherapy to combination therapy with rivaroxaban and a single antiplatelet in patients with atrial fibrillation and stable coronary disease, finding that monotherapy was equally effective in preventing major cardiovascular events but safer with less major bleeding.
The trial was terminated early due to higher mortality in the group receiving combination therapy, indicating potential risks associated with combining antithrombotic agents in this population.
Overall, rivaroxaban monotherapy may be a preferable option for antithrombotic treatment in these patients, offering similar protection against cardiovascular events with fewer safety concerns.
Aug 21, 2021 · 15 likes · 1 share · 6,152 followersView post →
PC
Prof Derek Connolly
@DrDerekConnolly · X
The Afire study of 2236 AF patients >1 yr post PCI/CABG/angioCAD
NOAC was non-inferior to combo NOAC/anti-platelet therapy for efficacy but SUPERIOR for bleeding
DOI: 10.1056/NEJMoa1904143
this sub-analysis shows this is irrespective of the risks of stroke/bleeding
@PCCS_UK https://t.co/UzRK6ipXD5
Mar 12, 2021 · 15 likes · 4 shares · 3,950 followersView post →
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David J. Cohen, MD, MSc
@djc795 · X
@Umair2017 @KemalogluOz @mirvatalasnag @KardiologieHH @ZainabDakhil2 @alaide_chief @mmamas1973 @gbiondizoccai @FrancescoPaneni @iamritu Only OAC-- I would consider this situation to be similar to AF and follow the lessons from the AFIRE trial. It's not perfect evidence but it feels right to me. https://t.co/J3Sw8r3sxG
Dec 23, 2023 · 12 likes · 1 share · 19,071 followersView post →
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Daniel Rey Aldana
@DanielReyAldana · X
Rivaroxaban en monoterapia frente Rivaroxaban+Antiagregante en #pacientes con #FA y cardiopatia isquemica estable. Antithrombotic Therapy for Atrial Fibrillation with Stable Coronary Disease | NEJM https://t.co/A008Lu6LAU https://t.co/RlixMkw8Jh
This week, John Mandrola MD discusses key findings from the Danish Cardiovascular Screening Trial. The trial, involving over 46,000 men aged 65-74, showed no significant reduction in mortality but indicated lower rates…
Prof. Bikdeli and Prof. Didier discuss the HIPRO study on extended treatment of provoked venous thromboembolism, presented at the 2025 European Society of Cardiology meeting. The study compares rivaroxaban monotherapy…
Prof Romain Didier and Prof Behnood Bikdeli discuss the AQUATIC study on antiplatelet drugs in patients with chronic coronary syndrome receiving oral anticoagulation, highlighting recent findings on therapy optimization…
@Umair2017 @KemalogluOz @mirvatalasnag @KardiologieHH @ZainabDakhil2 @alaide_chief @mmamas1973 @gbiondizoccai @FrancescoPaneni @iamritu Only OAC-- I would consider this situation to be similar to AF and follow the lessons from the AFIRE trial. It's not perfect evidence but it feels right to me. https://t.co/J3Sw8r3sxG
Dec 23, 2023 · 12 likes · 1 share · 19,071 followersView post →
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Stanley Liu, MD, FACC (he/him)
@Stanley_Liu_MD · X
@bmorecardiology I see it all the time and frequently take stable CAD/AF patients on double therapy off their anti-platelets assuming they remain on OAC. See AFIRE trial (rivaroxaban vs. rivaroxaban + anti-platelet, stopped early due to increased mortality in combo group) https://t.co/aX8Pgp6tBZ
Dec 9, 2023 · 2 shares · 8,481 followersView post →
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CardioNerds
@CardioNerds · X
RT @HanchateShivani: 6/ AFIRE trial
Dec 8, 2023 · 2 shares · 40,719 followersView post →
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Shivani Hanchate, MD
@HanchateShivani · X
6/ AFIRE trial
Dec 8, 2023 · 9 likes · 2 shares · 256 followersView post →
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William F McIntyre
@WFMMD · X
@KertViele @DrToddLee @bordistef @drjohnm @kaulcsmc @bogdienache Interestingly the NEJM was very funny with the AFIRE trial when they met non inferiority, then were superior but the journal would not let them claim that ..
https://t.co/uuwQmIFoeC
RT @BaoGTran: @richardbogle The bulk of the evidence say that once patient is stable, bleeding risk of combination DOAC and ASA outweighs b…
Aug 4, 2023 · 1 share · 4,583 followersView post →
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Bao Tran, MD
@BaoGTran · X
@richardbogle The bulk of the evidence say that once patient is stable, bleeding risk of combination DOAC and ASA outweighs benefits compared to DOAC alone in this scenario. https://t.co/5jncuLNcYk
Aug 3, 2023 · 7 likes · 1 share · 5,909 followersView post →
Today, I presented Journal Club reviewing the AFIRE trial (https://t.co/K0YN31eshX) @UAZHeart with Dr. Craig Hoover. I always analyze trials using the Race Analogy as taught by my mentor @ChrisDJacksonMD! It's the only way to make therapy trial results make sense to me. 1/2
May 15, 2022 · 9 likes · 4 shares · 4,360 followersView post →
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Sridhara S Yaddanapudi MD
@syaddana_neuro · X
How about doac ??
Afire trial took patients with stable cad and afib and showed the rivaroxiban monotherapy was equally effective and safer compared to anti platelet + rivaroxiban!! https://t.co/SQkWH6yzu9
May 13, 2022 · 2 likes · 2,551 followersView post →
Aug 21, 2021 · 15 likes · 1 share · 6,152 followersView post →
AS
Alec Schmaier
@ASchmaier · X
@adityasharmamd @heatherlgornik @GBarnesMD @EstherSHKimMD @2Scottish @YogenKanthi @SVM_tweets @DKadiandodov Cardiology fellow informed me of AFIRE trial.
https://t.co/FhTqWwnmzV
For stable CAD, riva noninferior to riva + aspirin for efficacy, superior for safety.
Anticoagulation alone is OK!
@drjohnm @JAMAInternalMed @GBarnesMD Arguably this was shown to be the case in AFIRE. Where the randomisation limited the biases and allowed a determination of treatment effect.
https://t.co/YQy5sOUtoZ
RT @DrDerekConnolly: The Afire study of 2236 AF patients >1 yr post PCI/CABG/angioCAD
NOAC was non-inferior to combo NOAC/anti-platelet t…
Mar 13, 2021 · 4 shares · 734 followersView post →
A
AmericanHeartJ
@AmericanHeartJ · X
RT @DrDerekConnolly: The Afire study of 2236 AF patients >1 yr post PCI/CABG/angioCAD
NOAC was non-inferior to combo NOAC/anti-platelet t…
Mar 13, 2021 · 4 shares · 10,567 followersView post →
JO
James Oldman
@James_OIdman · X
RT @DrDerekConnolly: The Afire study of 2236 AF patients >1 yr post PCI/CABG/angioCAD
NOAC was non-inferior to combo NOAC/anti-platelet t…
Mar 12, 2021 · 4 shares · 153 followersView post →
PC
Prof Derek Connolly
@DrDerekConnolly · X
The Afire study of 2236 AF patients >1 yr post PCI/CABG/angioCAD
NOAC was non-inferior to combo NOAC/anti-platelet therapy for efficacy but SUPERIOR for bleeding
DOI: 10.1056/NEJMoa1904143
this sub-analysis shows this is irrespective of the risks of stroke/bleeding
@PCCS_UK https://t.co/UzRK6ipXD5
Mar 12, 2021 · 15 likes · 4 shares · 3,950 followersView post →
LM
Lina Ya’Qoub MD
@yaqoub_lina · X
RT @aayshacader: #ESCardioAsia Dr Yasuda recaps #AFIRE trial
Rivaroxaban monotherapy non-inferior to combination therapy for efficacy & su…
Dec 6, 2020 · 4 shares · 2,219 followersView post →
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Luai Tabaza
@Tabaza · X
RT @aayshacader: #ESCardioAsia Dr Yasuda recaps #AFIRE trial
Rivaroxaban monotherapy non-inferior to combination therapy for efficacy & su…
Dec 5, 2020 · 4 shares · 2,187 followersView post →
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Dr Anastasia Mihailidou FAHA FCSANZ FESC
@AnastasiaSMihai · X
RT @aayshacader: #ESCardioAsia Dr Yasuda recaps #AFIRE trial
Rivaroxaban monotherapy non-inferior to combination therapy for efficacy & su…
Dec 5, 2020 · 4 shares · 19,402 followersView post →
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Rachna Kataria, MD
@rachkataria · X
RT @aayshacader: #ESCardioAsia Dr Yasuda recaps #AFIRE trial
Rivaroxaban monotherapy non-inferior to combination therapy for efficacy & su…
Dec 5, 2020 · 4 shares · 3,640 followersView post →
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Aaysha Cader
@aayshacader · X
#ESCardioAsia Dr Yasuda recaps #AFIRE trial
Rivaroxaban monotherapy non-inferior to combination therapy for efficacy & superior for safety in AF pts w stable CAD
Dec 5, 2020 · 10 likes · 4 shares · 9,108 followersView post →
AP
ACCP Adult Med PRN
@accpamedprn · X
Roshni Shibad: Antithrombotic therapy for atrial fibrillation with stable coronary disease. N Engl J Med. 2019;381(12):1103-1113.
Mentor: Craig Williams
3/
https://t.co/apfAI26aKi
WEBINAR ANNOUNCEMENT! Join the @AnticoagForum this THURSDAY for a webinar on Antithrombotic Therapy for Atrial Fibrillation with Stable Coronary Disease at 12:00 p.m. (ET-US). To register, please visit: https://t.co/92DjSQwSmQ
#WTDay20 https://t.co/WeQuBFlH45
Good time to review the #AFIRE trial: Showed rivaroxaban monotherapy was noninferior to combo Rx (with ASA) for efficacy and superior for safety in patients with atrial fibrillation and stable CAD (> 1 year out from PCI). ~30% with prior MI. https://t.co/7ulPMdYTlk
WTD PARTNER WEBINAR ANNOUNCEMENT: Join @AnticoagForum for a webinar on Antithrombotic Therapy for Atrial Fibrillation with Stable Coronary Disease on Thursday, 7/23/20 at 12:00 p.m. (ET-US). To register, visit: https://t.co/92DjSQwSmQ
#WTDay20 https://t.co/Ghe93QO7ab
AFIRE trial (2019)
2236 pts w/ Afib and stable CAD as defined above randomized to rivaroxaban vs rivaroxaban+antiplatelet.
Primary outcome - all cause mortality, MI, stroke, unstable angina requiring revasc, or systemic emb
https://t.co/KXcntliiIj
@ChrisZhouDO I think this is a good start but note that patients who have CAD and afib _DON'T_ need to be treated with both antiplatelet and anticoagulant therapy --> increased risks with no clear benefit:
https://t.co/mlS48ezhMJ
@FZores ... pour rebondir, même en attendant AQUATIC, on a déjà des éléments de réponse assez fort avec AFIRE je trouve : Antithrombotic Therapy for Atrial Fibrillation with Stable Coronary Disease | NEJM https://t.co/R5h4DRPHEh https://t.co/9JqAuqpTKQ
@PLooserMD https://t.co/cDsUhCtclc AFIRE trial would favor DOAC alone. But I would take anatomy into account as well (small stents? bifurcation stents?). In young patients like this our EP typically drop DOAC after a period of monitoring so then would resume antiplatelet after that
Nov 22, 2019 · 2 likes · 1 share · 5,909 followersView post →
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Michael Shook @mshook@mastodon.social
@mshook · X
RT @CianPMcCarthy: Will the AFIRE trial change your management of patients with stable CAD requiring concomitant anticoagulation?
https://…
AFIRE study gives us more confidence to use a DOAC alone in stable coronary artery disease patients (at least 12 months after PCI). Thank @GBarnesMD for the great talk @ThrombosisCan
#knowthrombosis https://t.co/cmKEVapBAj
Antithrombotic Therapy for Atrial Fibrillation with Stable Coronary Disease | NEJM https://t.co/ArZtLAJZCQ #Rivaroxaban #AFib
Oct 8, 2019 · 1 like · 3 shares · 2,135 followersView post →
HP
Haylin Huang, PharmD
@HaylinPharmD · X
#OTILT New trial from Japan (N Engl J Med 2019) showed rivaroxaban monotherapy was noninferior to combo therapy with antiplatelets for primary efficacy endpoints and SUPERIOR in terms of safety aka major bleeding in #Afib and #CAD patients. #TwitteRx
https://t.co/oT1sZ7ItUN
A new study is out in the New England Journal of Medicine called "Antithrombotic Therapy for Atrial Fibrillation with Stable Coronary Disease."
You can request this article through your library resources.
https://t.co/9m1oaVs4Pi
I think these findings are very interesting given the prevalence of #Afib in our patient population. Is it much of a stretch to consider these results in patients with stable #PAD more than 1 year after treatment? Thoughts? @jmills1955 @NealBarshes
https://t.co/HELGkxRd8m
En este caso menos es más #cardiacsurgery #prevention #atrialfibrillation Antithrombotic Therapy for Atrial Fibrillation with Stable Coronary Disease | NEJM https://t.co/h76iACk5gz
Tareq Islam, our #hospitalist #research expert leading our monthly #JournalClub today at #WakeHospitalMedicine on "Antithrombotic Therapy for Atrial Fibrillation with Stable Coronary Disease." What a fantastic discussion and a great way to end the week! https://t.co/ilz1RfLmn6
Rivaroxaban en monoterapia frente Rivaroxaban+Antiagregante en #pacientes con #FA y cardiopatia isquemica estable. Antithrombotic Therapy for Atrial Fibrillation with Stable Coronary Disease | NEJM https://t.co/A008Lu6LAU https://t.co/RlixMkw8Jh
Antithrombotic Therapy for Atrial Fibrillation with Stable Coronary Disease | NEJM
"The trial was stopped early because of increased mortality in the combination-therapy group"...
https://t.co/WQ9g8GwgQl https://t.co/lqppPYUVgc
Antithrombotic Therapy for Atrial Fibrillation with Stable Coronary Disease | via @NEJM. Spoiler...DOAC is just fine, don't need the antiplatelet agent if stable CAD. https://t.co/AwLS8xKaqP
Sep 9, 2019 · 1 like · 12,267 followersView post →
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kkurimpt
@kkurimpt · X
RT @kojima_aponet: 【N Engl J Med】
Antithrombotic Therapy for Atrial Fibrillation with Stable Coronary Disease.
https://t.co/cTb2OlIRYp
Antithrombotic Therapy for Atrial Fibrillation with Stable Coronary Disease | NEJM
#NOACs alone is effictive and safer than triple therapy
PS
-stable coronary disease has new name; "chronic coronary syndrome" #CCS ✔️
https://t.co/CwEQFQJcyo https://t.co/ASK2gbHEJi
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