Evidence map›Paper›PMID 41486379›Full record

Trial reportHypertension research : official journal of the Japanese Society of Hypertension2026

Prognostic impact of systolic blood pressure and antithrombotic strategy in patients with atrial fibrillation and stable coronary artery disease: a post-hoc analysis of the AFIRE trial.

Shinichi Yamanaka, Takashi Noda, Kotaro Nochioka, Takumi Higuma, Koichi Kaikita, Masaharu Akao, Junya Ako, Tetsuya Matoba, Masato Nakamura, Katsumi Miyauchi and 6 more

Abstract readRandomized Controlled TrialMulticenter Study
In one paragraph

Trial report in Hypertension research : official journal of the Japanese Society of Hypertension, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

16 authors.

Shinichi YamanakaDepartment of Cardiovascular Medicine, Tohoku University Graduate, School of Medicine, Sendai, Japan.
Takashi NodaCardiovascular Center, Kinki University hospital, Osakasayama, Japan.
Kotaro NochiokaDepartment of Cardiovascular Medicine, Tohoku University Graduate, School of Medicine, Sendai, Japan.
Takumi HigumaDepartment of Cardiology, Kawasaki Municipal Tama Hospital, Kawasaki, Japan.
Koichi KaikitaDivision of Cardiovascular Medicine and Nephrology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan.
Masaharu AkaoDepartment of Cardiology, National Hospital Organization Kyoto Medical Center, Kyoto, Japan.
Junya AkoDepartment of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan.
Tetsuya MatobaDepartment of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan.
Masato NakamuraDivision of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan.
Katsumi MiyauchiDepartment of Cardiovascular Medicine Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan.
Nobuhisa HagiwaraDepartment of Cardiology, Tokyo Women's Medical University, Tokyo, Japan.
Kazuo KimuraCardiovascular Center, Yokohama City University Medical Center, Yokohama, Japan.
Kunihiko MatsuiDepartment of General Medicine and Primary Care, Kumamoto University Hospital, Kumamoto, Japan.
Hisao OgawaKumamoto University, Kumamoto, Japan.
Satoshi YasudaDepartment of Cardiovascular Medicine, Tohoku University Graduate, School of Medicine, Sendai, Japan. satoshi.yasuda.c8@tohoku.ac.jp.
AFIRE Investigators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundsThe AFIRE (Atrial Fibrillation and Ischemic Events with Rivaroxaban in Patients with Stable Coronary Artery Disease) trial demonstrated that rivaroxaban monotherapy was non-inferior in efficacy and superior in safety compared to rivaroxaban plus single antiplatelet therapy in patients with atrial fibrillation (AF) and stable coronary artery disease (CAD). This study examined whether systolic blood pressure (SBP) affects clinical outcomes and modifies the impact of antithrombotic therapy.

methodsIn this post hoc analysis, participants were stratified based on median SBP at baseline: >126 mmHg (High SBP group, n = 1042) and ≤126 mmHg (Low SBP group, n = 1093). The primary efficacy endpoint was a composite of cardiovascular events and all-cause death. The primary safety endpoint was major bleeding.

resultsThe mean SBP was 139 mmHg and 114 mmHg in the High and Low SBP groups, respectively. In the propensity score-matched cohort (n = 1684), the Low SBP group had a significantly higher incidence of the primary efficacy endpoint (hazard ratio [HR], 1.38; 95% confidence interval [CI], 1.01-1.88; p = 0.039), while the primary safety endpoint was comparable between groups. In the Low SBP group, rivaroxaban monotherapy was associated with lower risks of both the primary efficacy (HR, 0.60; 95% CI, 0.41-0.86; p = 0.006) and safety endpoints (HR, 0.40; 95% CI, 0.22-0.74; p = 0.003) compared with combination therapy, whereas no significant differences were observed in the High SBP group.

conclusionsLower SBP was associated with increased risk of cardiovascular events and all-cause death. Rivaroxaban monotherapy demonstrated more favorable efficacy and safety outcomes particularly patients with lower SBP.

Indexed as

Atrial FibrillationBlood PressureCoronary Artery DiseaseFactor Xa InhibitorsFibrinolytic AgentsRivaroxabanAgedFemaleHumansMaleMiddle AgedPlatelet Aggregation InhibitorsPrognosisTreatment OutcomeFactor Xa InhibitorsFibrinolytic AgentsPlatelet Aggregation InhibitorsRivaroxabanAtrial fibrillationCoronary artery diseaseMonotherapySystolic blood pressure

Identifiers

PMID41486379
PMCPMC13050638

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.