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RecruitingNCT07753200SMARTDECISION3Updated Aug 10, 2026

Net Clinical Benefit of Edoxaban Versus Apixaban in Patients With Atrial Fibrillation and Coronary Artery Disease

A Phase 4 interventional study of Edoxaban and Apixaban in Atrial Fibrillation (AF) and Coronary Arterial Disease (CAD), sponsored by Samsung Medical Center. Recruiting at 1 site in South Korea. Open to participants aged 19 Years and older. Per ClinicalTrials.gov, last updated 2026-08-10.

Sponsored by Samsung Medical Center · Phase 4, Interventional, and Treatment

From the registry’s dates

  • Started Jul 2026; still recruiting 3 months later.
Phase
Phase 4
Study type
Interventional
Enrollment
3,000
Allocation
Randomized
Ages
19 Years and older
Sex
All
01

Study summary

Non-vitamin K antagonist oral anticoagulants(NOACs) are standard care for thromboembolism prevention in patients with Aterial Fibrillation(AF). However, evidence comparing edoxaban and apixaban remains limited in AF patients with coexisting coronary artery disease(CAD). This study aims to evaluate whether edoxaban-based therapy is non-interior to apixaban-based therapy with respect to Net Adverse Clinical Events(NACE) in AF patients with concomitant CAD.

Read the detailed description

Non-vitamin K antagonist oral anticoagulants (NOACs) have become the standard of care for the prevention of thromboembolic events in patients with AF. In patients with AF and concomitant CAD, the choice of oral anticoagulant is particularly important because clinicians must balance the risks of thromboembolism, coronary ischemic events, as well as bleeding. Among available NOACs, apixaban and edoxaban share a common mechanism of factor Xa inhibition but differ substantially in dosing regimen, pharmacokinetic profile, and degree of renal elimination. In the recent COBRRA trial, apixaban was associated with significantly lower clinically relevant bleeding compared with rivaroxaban in patients with acute venous thromboembolism, without compromising efficacy against recurrent thromboembolism. Although these data support apixaban as an important benchmark NOAC, direct randomized comparisons between edoxaban and apixaban are lacking, particularly in patients with AF and coexisting CAD. Once-daily dosing and lower renal elimination fraction of edoxaban may offer practical advantages, particularly in elderly patients or those with impaired renal function, by potentially improving adherence and simplifying dose adjustment. Whether these pharmacological differences translate into meaningful differences in overall clinical outcomes remains uncertain. Given that anticoagulation strategies inherently require balancing thromboembolic protection against bleeding risk, evaluation using a net clinical outcome is clinically most relevant. Therefore, this randomized controlled trial is designed to determine whether edoxaban-based therapy is non-inferior to apixaban with respect to NACE, a composite of death, thromboembolic, and major bleeding outcomes in patients with AF and concomitant CAD.

02

Conditions studied

  • Atrial Fibrillation (AF)
  • Coronary Arterial Disease (CAD)

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03

In context

Atrial Fibrillation

4,009 studies on the registry are indexed under Atrial Fibrillation; 961 are open to participants now.

This study's planned enrollment of 3,000 is above the median of 150 across 2,476 interventional studies indexed under Atrial Fibrillation.

Browse Atrial Fibrillation studies →

Lead sponsor

Samsung Medical Center is the lead sponsor of 1,011 studies on the registry; 152 are open to participants now.

Of its 7 completed or terminated interventional studies of FDA-regulated products, 1 (14%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
19 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Patients must be at least 19 years of age
  • Patients with AF requiring oral anticoagulation therapy (CHA2DS2-VaSc 2 or more)
  • Documented coronary artery disease, defined as at least one of the following: history of percutaneous coronary intervention (PCI), history of coronary artery bypass grafting (CABG), major epicardial coronary artery stenosis ≥50% on coronary computed tomography angiography (CCTA) or invasive coronary angiography
  • Patients who can understand risks, benefits and treatment alternatives and sign voluntarily.

Exclusion criteria

Exclusion Criteria:

  • Known or to study medications (apixaban or edoxaban)
  • Severe renal impairment ( \<15 mL/min) or dialysis
  • Active major bleeding
  • Indication requiring alternative anticoagulation (e.g., mechanical valve surgery or moderate / severe mitral stenosis)
  • Non-cardiac co-morbid conditions are present with \<1 year or that may result in protocol non-compliance (per site investigator's medical judgment)
  • Pregnant or lactating women
Terms in these criteria, in plain language(5)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

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You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

Creatinine clearance (CrCl)

How quickly the kidneys clear creatinine, a waste product, from the blood. A study may estimate it from a blood test with age, weight and sex (often by the Cockcroft–Gault formula), or measure it using blood and urine collected over a set time. Given in mL/min; higher is better.

Life expectancy

The study doctor’s estimate of how long someone is likely to live. Criteria use it so that people can stay in the study long enough for it to answer its question.

05

Study design

Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Investigator)
Enrollment
3,000 participants (estimated)

Study arms

  • Experimental
    Edoxaban-based treatment group

    Edoxaban 60mg once daily orally, continue until follow-up is complete.

    Drug: Edoxaban

  • Active comparator
    Apixaban-based treatment group

    Apixaban 5mg twice a day orally, continue until follow-up is complete.

    Drug: Apixaban

Interventions

  • Edoxaban 60mg will be administered once daily orally according to the study protocol.

    Also known as: Lixiana

  • Apixaban 5mg will be administered twice a day orally according to the study protocol.

    Also known as: Eliquis

06

What researchers measure

Primary outcomes

  1. Net Adverse Clinical Events (NACE)

    A composite of death from any causes, Myocardial Infarction, Stroke, systemic embolic events or International Society on Thrombosis and Hemostasis major bleeding

    Time frame: 5 years

Secondary outcomes

  1. Major Adverse Cardiovascular and Cerebrovascular Events (MACEE)

    a composite of death from any causes, Myocardial Infarction, or Stroke

    Time frame: 5 years

07

Study locations

1 of 1 sites recruiting
08

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Started Jul 2026 (actual). Primary completion is estimated for Jun 2031, 58 months after the start.

Of 129 non-industry phase 4 interventional studies under Atrial Fibrillation, half reached primary completion within 53 months of starting (the median), counting those still running; a quarter within 28 and three quarters within 81. This study's planned 58 months is close to that.

Counting every sponsor, half of 141 studies reached it within 48 months; a quarter within 27 and three quarters within 81.

How these figures are worked out, and which studies are left out of them.

Registered
Jul 31, 2026
First posted
Aug 7, 2026
StartActual
Jul 20, 2026
Primary completionEst.
Jun 1, 2031
CompletionEst.
Dec 31, 2031
Last update
Aug 10, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Aug 10, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT07753200
Responsible party
Joo-Yong Hahn (Professor, Samsung Medical Center) — Principal investigator
First posted
Aug 7, 2026
Start date
Jul 20, 2026
Primary completion
Jun 1, 2031 (estimated)
Completion
Dec 31, 2031 (estimated)
Last update
Aug 10, 2026

Study contacts

Joo-Yong Hahn, MD, PhD
Contact
Jooyong.hahn@gmail.com
82-2-3410-6653
Ki-Hong Choi, MD, PhD
Contact
cardiokh@gmail.com
82-2-3410-6653
Joo-yong Hahn, MD, PhD
principal investigator · Samsung Medical Center

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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Studies of the drug tested here: Edoxaban

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