P2Y12 Inhibitor is a type of medication that helps prevent blood clots by stopping platelets in the blood from sticking together. In this trial, it is used as a monotherapy for one month to see if it can safely reduce the risk of bleeding and prevent major heart and brain events in patients with atrial fibrillation who have had a coronary stent implanted.

Direct-Acting Oral Anticoagulant (DOAC) is a medication that helps prevent blood clots by thinning the blood. In this study, it is used after the initial P2Y12 inhibitor monotherapy. The trial aims to determine if using DOAC alone long-term is as effective and safe as the current standard treatment, which involves a combination of medications.

Atrial Fibrillation – Atrial fibrillation is a common heart rhythm disorder where the heart’s upper chambers (atria) beat irregularly and often rapidly. This can lead to poor blood flow and may cause symptoms like palpitations, shortness of breath, and fatigue. Over time, atrial fibrillation can increase the risk of stroke and heart failure. The condition can be persistent or occur in episodes, and its severity can vary among individuals. It often requires ongoing management to control the heart rate and reduce the risk of complications.

Myocardial Infarction – Myocardial infarction, commonly known as a heart attack, occurs when blood flow to a part of the heart is blocked for a long enough time that part of the heart muscle is damaged or dies. This is usually due to a blockage in one or more of the coronary arteries. Symptoms often include chest pain, shortness of breath, and discomfort in the upper body. The severity of a heart attack can vary, and it can lead to significant heart damage if not addressed promptly. Recovery and progression depend on the extent of the damage and the individual’s overall health.

Stroke – A stroke happens when the blood supply to part of the brain is interrupted or reduced, preventing brain tissue from getting oxygen and nutrients. This can cause brain cells to die within minutes. Symptoms may include sudden numbness, confusion, trouble speaking, and difficulty walking. Strokes can be classified as ischemic, due to a blockage, or hemorrhagic, due to bleeding. The effects of a stroke depend on the area of the brain affected and the extent of the damage. Early intervention is crucial to minimize long-term effects.

Stent Thrombosis – Stent thrombosis is a rare but serious complication that occurs when a blood clot forms on a stent placed in a coronary artery. This can lead to a sudden blockage of the artery, potentially causing a heart attack. It can occur shortly after stent placement or even months later. Symptoms may include chest pain and other signs of a heart attack. The risk of stent thrombosis can be influenced by factors such as stent type, patient health, and adherence to prescribed medications.

Transient Ischemic Attack – A transient ischemic attack (TIA), often called a mini-stroke, occurs when there is a temporary decrease in blood supply to part of the brain. Symptoms are similar to those of a stroke but are temporary and usually resolve within minutes to hours. TIAs do not cause permanent damage but are often a warning sign of a future stroke. They can be caused by a variety of factors, including blood clots and narrowed blood vessels. Recognizing and addressing the underlying causes of a TIA is important to prevent a full stroke.