There were no signi cant differences for the secondary combined ischemic end point of cardiac death, MI, de nite stent thrombosis, and 95% CI, 0.43-2.05; P .87) or the secondary bleeding end point of Thrombolysis In Myocardial Infarction 95% CI, 0.64-2.84; P .44). Thus, 6 weeks of triple therapy was not superior to 6 months of therapy with respect to net clinical outcomes, suggesting that physicians should weigh the trade-off between ischemic and bleeding risk when choosing a shorter or longer duration of triple therapy. In an open-label, randomized, controlled, multicenter study exploring two treatment strategies of rivaroxaban and a dose-adjusted oral vitamin K antagonist treatment strategy in subjects with atrial brillation who undergo percutaneous coronary intervention (PIONEER AF- 2,124 patients with AF undergoing PCI with stenting were randomized to low-dose rivaroxaban (15 mg once daily, reduced to 10 mg with moderate renal impairment) plus a P2Y12 inhibitor for 12 months (group 1), very-low-dose rivaroxaban (2.5 mg twice daily) plus DAPT for 1, 6, or 12 months (group 2), or standard VKA (once daily) plus DAPT for 1, 6, or 12 months (group 3). The rates of clinically signi cant bleeding were lower in the 2 groups receiving rivaroxaban than in the VKA group (16.8% in group 1, 18.0% in group 2, and 26.7% in group 3; HR for group 1 group 2 vs group 3, 0.63; 95% CI, 0.50-0.80; P < .001). The rates of death from cardiovascular causes, MI, or stroke were similar in the 3 groups, but the trial was underpowered for ef cacy end points. There was only a minority of newer P2Y12 inhibitors used as APT. 