{"id":"1a5f2aeadce4","type":"article","url":"https://hartvaat.nl/2026/07/31/15-mg-edoxaban-na-pci-bij-atriumfibrilleren-met-hoog-bloedingrisico-geen-superie/","title":"15 mg edoxaban na PCI bij atriumfibrilleren met hoog bloedingrisico — geen superieure uitkomst","title_en":"Efficacy of 15 mg Edoxaban on Long-Term Outcome after Percutaneous Coronary Intervention in Patients with Atrial Fibrillation and High Bleeding Risk.","category":"atriumfibrilleren","category_label":"Atriumfibrilleren","professions":["apotheker","cardioloog","huisarts"],"tags":[],"journal":"International heart journal","doi":"10.1536/ihj.25-558","source_url":"https://doi.org/10.1536/ihj.25-558","authors":["Takao Sato","Yoshifusa Aizawa","Toshihiro Miyamoto","Ryoma Fukuoka","Kazumasa Sugimoto","Yoko Tanimoto","Takashi Nakayama","Kojiro Tanimoto","Koichiro Sugimura","Yoshihide Fujimoto","Takahiko Kiyooka","Akio Kawamura"],"significance":4,"published":"2026-08-15","source_date":"2026-07-31","image":"","kennis":["https://hartvaat.nl/kennis/atriumfibrilleren/af-bij-ouderen/","https://hartvaat.nl/kennis/atriumfibrilleren/af-en-beroerte/"],"congress":"","summary_en":"A retrospective analysis of 148 patients with atrial fibrillation undergoing PCI compared 15 mg versus 30 mg edoxaban in those at high bleeding risk. Although the 15 mg dose showed numerically lower rates of major bleeding (6.8% vs 19.7%) and thrombotic events (3.0% vs 7.4%), these differences did not reach statistical significance. Clinicians should note that current evidence does not support switching to the lower edoxaban dose over the standard 30 mg regimen in this high-risk population.","created":"2026-08-09T01:18:42Z","updated":"2026-08-10T10:35:26Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Een retrospectieve analyse van 148 patiënten met atriumfibrilleren die een PCI ondergingen, vergeleek de effectiviteit van 15 mg versus 30 mg edoxaban bij patiënten met een hoog bloedingrisico. Hoewel de 15 mg-dosering numeriek lagere incidenties van major bloedingen (6,8% versus 19,7%) en trombotische events (3,0% versus 7,4%) liet zien, bereikten deze verschillen geen statistische significantie. Voor de klinische praktijk bevestigt dit dat er bij deze kwetsbare groep geen bewijs is voor het overstappen op de lagere dosis edoxaban boven de standaard 30 mg.","abstract_original":"In patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention (PCI), dual antiplatelet therapy (DAPT) plus oral anticoagulants increase bleeding risk. Low-dose edoxaban (15 mg) is safe for high-risk older patients with AF; however, its role after PCI compared with the standard 30 mg dose remains unclear. We aimed to compare outcomes of 15 mg and 30 mg edoxaban after PCI.We retrospectively analyzed data from patients with AF undergoing PCI for acute coronary syndrome who received edoxaban 30 mg (n = 99) or 15 mg (n = 49). During admission, DAPT was transitioned to P2Y12 inhibitor monotherapy. Bleeding and thrombotic events were assessed over 2 years, alongside CHADS2, HAS-BLED, and CREDO-Kyoto scores.Compared with 30 mg edoxaban, patients on 15 mg edoxaban were older (86 ± 2 versus 80 ± 6 years, P< 0.01) and had lower hemoglobin levels and body mass index (19.4 ± 3.1 versus 22.7 ± 2.7, P < 0.01) but higher CHADS2 (3.3 ± 0.9 versus 2.8 ± 0.9, P < 0.01), HAS-BLED (3.2 ± 0.9 versus 2.6 ± 0.6, P < 0.01), and CREDO-Kyoto thrombotic and bleeding (5.0 ± 1.1 versus 4.0 ± 1.8, P < 0.01; and 4.1 ± 1.7 versus 2.7 ± 1.2, P < 0.01, respectively) scores. Major bleeding, including clinically relevant non-major bleeding, was more frequent in the 30 mg group (19.7% versus 6.8%, P = 0.08); thrombotic events were comparable (7.4% versus 3.0%, P = 0.35).In weighted Cox analysis, 15 mg edoxaban showed numerically lower hazard ratios for thrombotic (HR: 0.12, 95% CI: 0.01-1.17; P = 0.09) and bleeding (HR: 0.24, 95% CI: 0.06-1.29; P = 0.07) events compared with 30 mg, although these differences did not reach statistical significance.Among older high bleeding-risk patients with AF undergoing PCI, 15 mg edoxaban did not demonstrate superiority over 30 mg with respect to thrombotic or bleeding outcomes."}