The document discusses insights from the AUGUSTUS trial regarding how long to continue aspirin after an acute coronary syndrome (ACS) or percutaneous coronary intervention (PCI) in patients with atrial fibrillation (AF). The objective was to explore the balance of risk and benefit of aspirin versus placebo between randomization and 30 days and between 30 days and 6 months. The conclusions were that aspirin increased both severe bleeding and reduced severe ischemic events up to 30 days, but after 30 days only increased bleeding without significantly reducing ischemic events. This should inform decisions about the ideal duration of aspirin after ACS/PCI in patients with AF on oral anticoagulation.

1. Aspirin after ACS/PCI In AF. Insights from AUGUSTUS María Thiscal López Lluva
How Long To Continue Aspirin After ACS/PCI
In Patients With Atrial Fibrillation?
Insights From AUGUSTUS

2. Aspirin after ACS/PCI In AF. Insights from AUGUSTUS María Thiscal López Lluva

3. Aspirin after ACS/PCI In AF. Insights from AUGUSTUS María Thiscal López Lluva

4. Aspirin after ACS/PCI In AF. Insights from AUGUSTUS María Thiscal López Lluva

5. Aspirin after ACS/PCI In AF. Insights from AUGUSTUS María Thiscal López Lluva
OBJECTIVE
To explore the balance of risk (bleeding) and benefit (ischemic events) between randomization and 30 days and
between 30 days and 6 months, with aspirin and placebo, among patients enrolled in AUGUSTUS

6. Aspirin after ACS/PCI In AF. Insights from AUGUSTUS María Thiscal López Lluva

7. Aspirin after ACS/PCI In AF. Insights from AUGUSTUS María Thiscal López Lluva

8. Aspirin after ACS/PCI In AF. Insights from AUGUSTUS María Thiscal López Lluva

9. Aspirin after ACS/PCI In AF. Insights from AUGUSTUS María Thiscal López Lluva
CONCLUSIONS
Among patients with atrial fibrillation and a recent ACS or PCI receiving a P2Y12 inhibitor and oral anticoagulation with
apixaban or warfarin
- The use of aspirin acutely and for up to approximately 30 days results in an equal increase in severe bleeding
and reduction in severe ischemic events
- After 30 days, aspirin continues to increase bleeding without significantly reducing ischemic events
These results should inform patient-centric, shared decisión making regarding the ideal duration of aspirin after an
ACS or PCI in patients with atrial fibrillation receiving oral anticoagulation