News
Greenslopes leads the way in international 'triple therapy' heart study
Apr 29, 2019
Greenslopes Private Hospital was the largest trial site in Australia for a large global study focusing on high-risk cardiac patients.
‘AUGUSTUS’ is a randomised controlled trial involving patients who require both anticoagulants (blood thinning medication) and antiplatelet therapies (used to prevent blood clots forming in the arteries).
The study was designed to compare two treatments: the new anticoagulant ‘Apixaban’ versus the old Warfarin. Researchers specifically focused on non-valvular atrial fibrillation patients with acute coronary syndrome (ACS) and/or undergoing percutaneous coronary intervention (PCI).
In the trial, atrial fibrillation patients received either Apixaban or Warfarin, as well as aspirin or matching placebo on top of their usual post PCI antiplatelet – usually Plavix.
Clinical Cardiologist Associate Professor David Colquhoun was the Prinicipal Investigator, while Interventional Cardiologist and Chair of the Cardiology Craft Group, Dr Paul Watson, provided most of the patients at Greenslopes Private Hospital.
A/Professor Colquhoun said: “Previously, when a patient had both atrial fibrillation and unstable angina, which can lead to a heart attack, we didn’t have concrete clinical evidence to back up which treatment path was most suitable.”
“What the ‘AUGUSTUS’ trial has done is to clearly show us that Apixaban is superior to Warfarin in terms of lower bleeding rates,” A/Professor Colquhoun said.
“Patients using antiplatelet therapies with or without aspirin had lower rates of major or clinically relevant non-major bleeding when they were also treated with Apixaban, compared to those who were also treated with Warfarin.”
“Importantly, patients who had aspirin in addition to their usual anti-platelet suffered significantly higher rates of bleeding with no clinical benefit.”
A/Professor Colquhoun said the study would be discussed at a forthcoming research meeting of the Cardiology Craft Group and lead to improved clinical practice, with Greenslopes Private Hospital leading the way in the best-evidence clinical management of these patients.
“These findings translate very easily into our current methods and will play an important role when formulating treatment pathways for our patients in the future,” A/Professor Colquhoun said.
A/Professor Colquhoun is a board member of the National Heart Foundation of Australia, which is marking its 60th anniversary in 2019.
Heart Week runs from 28 April until 4 May 2019.