ESC Congress 2024 — Edoxaban monotherapy significantly improves outcomes in high-risk patients with CAD and atrial fibrillation.

Investigators, Dr Gi-Byoung Nam (Ulsan University Hospital, Ulsan, SK) and Dr Min Soo Cho (Asan Medical Center, Seoul, SK) join us to discuss the key findings from the EPIC-CAD trial (NCT03718559).

This Korean multi-centre, open-labelled, randomised controlled study investigated the effectiveness and safety of edoxaban monotherapy compared to edoxaban combined with an antiplatelet agent in 1040 patients with stable coronary artery disease (CAD) with a stenosis of at least 50% on medical management or post-revascularisation (at least 12 months after acute coronary syndrome or 6 months after stable CAD), and who also have a high risk of atrial fibrillation (CHA2DS2-VASc score ≥2). The primary outcome measure was a composite of clinical events at one year.

Findings showed that edoxaban monotherapy significantly reduced the risk of a net composite outcome of death by any cause, stroke, systemic embolism, myocardial infarction unplanned revascularisation and major or clinically relevant non-major bleeding at one year after revascularisation by 56% compared with dual antithrombotic therapy. 

Interview Questions: 

1. What is the importance of this trial?
2. What was the study design, eligibility criteria and outcome measures?
3. What were the baseline characteristics of randomised patients?
4. What are the key findings? (Safety and efficacy)
5. Were there any significant differences in treatment effect between pre-specified sub-groups of patients?
6. What conclusions can be made for practice?
7. What are the next steps?

Recorded on-site at ESC Congress 2024, London.

Editors: Jordan Rance and Mirjam Boros.
Videographers: Mike Knight, Dan Brent, Oliver Miles, Tom Green, David-Ben-Harosh.

Support: This is an independent interview produced by Radcliffe Cardiology.