PIONEER AF-PCI was an international, randomized, open-label trial investigating safety and effectiveness of standard anticoagulation with vitamin K antagonist plus dual antiplatelet therapy in comparison to low-dose rivaroxaban plus platelet P2Y12 receptor inhibitor or very-low-dose rivaroxaban plus dual antiplatelet therapy in 2,124 patients with atrial fibrillation who underwent percutaneous coronary intervention with stent implantation. The rates of primary safety outcome - clinically significant bleeding - were lower in both groups receiving rivaroxaban than in the group receiving standard therapy.
The rates of death from cardiovascular causes, myocardial infarction, or stroke were similar in the three groups. In post-hoc analysis, all-cause death or rehospitalization was lower with both rivaroxaban-based strategies compared with standard antithrombotic therapy.