health at Greenslopes Private Hospital
Leading the way in international ‘triple therapy’
heart study
greenslopesprivate.com.au | 7
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 bestevidence
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.