Research presented at the American Heart Association's Scientific Sessions 2025 indicates that a simplified medication regimen for preventing blood clots after stent placement in atrial fibrillation patients may provide comparable cardiovascular protection with substantially reduced bleeding risks. The OPTIMA-AF trial, involving 1,101 adults in Japan with an average age of 75.2 years, compared two approaches: one group received both a direct oral anticoagulant and a P2Y12 inhibitor for one month followed by only the oral anticoagulant for the remaining 11 months, while the other group continued dual therapy for the full 12-month period.
Results demonstrated that 5.4% of participants in the one-month group and 4.5% in the 12-month group experienced heart attack, stroke or death, showing comparable effectiveness between approaches. More significantly, the one-month dual-treatment group experienced notably fewer bleeding complications—4.8% versus 9.5% in the 12-month group. Most of this reduction came from less serious bleeds that still required medical attention, which can affect quality of life and increase healthcare costs.
Study author Yohei Sotomi, M.D., Ph.D., explained that standard treatment after stent implantation typically involves two clot-preventing medications for one year, but these medications can increase the risk of serious bleeding. "Our study is the first to show that a one-month strategy is both safe and effective, offering real-world benefits for patients and doctors," Sotomi said. The findings are particularly relevant given that up to one in ten people who receive stents also have atrial fibrillation, a disorder that increases stroke risk by five-fold and can lead to blood clots, heart failure and death.
According to American Heart Association 2025 Heart and Stroke statistics, an estimated five million adults in the U.S. have AFib, with projections suggesting more than 12 million Americans will have the condition by 2030. Additional information about AFib and heart health is available at https://www.heart.org/en/health-topics/atrial-fibrillation. While the study represents an important advancement in cardiovascular care, researchers noted several limitations including its exclusive conduct in Japan, which may limit applicability to other populations, and the inclusion of only about 20% women, limiting generalizability to female patients.
The study was presented as part of the American Heart Association's Scientific Sessions 2025, a premier global exchange of the latest scientific advancements in cardiovascular science. The abstract can be viewed in the American Heart Association Scientific Sessions 2025 Online Program Planner at https://professional.heart.org/en/meetings/scientific-sessions. It's important to note that the findings are considered preliminary until published as a full manuscript in a peer-reviewed scientific journal, as abstracts presented at the Association's scientific meetings are not peer-reviewed.
