INTERNAL USE ONLY   AUGUSTUS in the spotlight at EuroPCR 2019 Paris, 22 May 2019 Dear colleagues, Following a significant presence at EHRA in March, and to round off a successful Spring 2019, at the same time as ESOC congress in Milan the Alliance also sponsored a key satellite symposium at EuroPCR in Paris: Optimising anticoagulation management in atrial fibrillation: focus on patients with concomitant ACS and/or undergoing PCI. Our primary goal was to bring the AUGUSTUS data and clinical insights to the predominantly interventional cardiologist audience at EuroPCR. Given the relevance of this topic to this audience, the room was well filled to around 80% capacity – despite being one of the 14 parallel ongoing sessions of EuroPCR. To engage delegates throughout the 90-minute session, we had invited four eminent Professors with a wealth of cardiology expertise. Martine Gilard Stephan Windecker Current consensus and outstanding questions in NVAF and ACS/PCI Co-chair Professor Martine Gilard, President of the French Society of Cardiology, opened the session with a recap of NOAC achievements to date. Professor Stephan Windecker from Switzerland, Chair of the ESC Clinical Practice Guidelines committee, discussed the current consensus and questions on anticoagulation and antiplatelet therapy in NVAF patients with ACS. Rob Storey Nicolas Meneveau AUGUSTUS: A different focus for an interventionalist audience For the interventionalist audience at EuroPCR, our faculty split the AUGUSTUS outcomes into two presentations. This gave them more time to separately discuss the two different hypotheses, uniquely addressed by this trial, with its 2 x 2 factorial design. With the main focus of the symposium being the new evidence from AUGUSTUS, Professor Robert Storey from the UK (our second Co-chair) presented the study design and key results. He highlighted the impressive 31% relative risk reduction in major or CRNM bleeding with apixaban vs VKA, regardless of aspirin use. The 89% greater risk of major or CRNM bleeding with aspirin vs aspirin placebo was another impactful point in his talk. Professor Nicolas Meneveau from France further expanded on the aspirin vs aspirin placebo results in AUGUSTUS – especially relevant to this audience. In particular, Professor Meneveau discussed the potential impact of the evidence AUGUSTUS provided on the choice of dual vs triple therapy in NVAF patients with ACS and/or PCI, and on the continued debate on duration of aspirin use around PCI. Our panel of four eminent cardiology Professors Tackling the key questions The symposium also provided a forum for practical conversations on the clinical implications of AUGUSTUS, and how the findings could influence guidelines and standards of care. The audience seized the opportunity to join a lively 30-minute discussion, asking challenging questions of the panel. Questions came from more junior physicians, as well as more experienced cardiologists who hold leading positions in their organisations. Topics included: how to define ‘early’ aspirin discontinuation; how to simplify recommendations on adding aspirin; DOAC dosing and DOAC selection; and differences between ticagrelor and clopidogrel. Highly engaged audience at the Alliance symposium The symposium was another very successful event for the Alliance – delivering key clinical insights from AUGUSTUS to a highly relevant audience. Delegates were actively taking notes and photographs throughout the presentations and Q&A. • Over 90% of respondents were satisfied or highly satisfied with the symposium content • All respondents agreed that their expectations had been met Access the EuroPCR 2019 symposium slides here on the EuroPCR website after logging in or registering for a free account. Next up for 2019... Thank you to the Lucid team who helped us manage the symposium, and very special thanks to the local Alliance medical team for supporting us at EuroPCR 2019. Many of us are currently busy continuing this year’s successes towards ISTH, 6–10 July, and the ESC congress, 31 Aug–4 Sep. Yours sincerely, The EuroPCR medical team: Alexandra Haddad (Pfizer), Anthony Chan (Pfizer), Christian Klem (BMS), and Jose Chaves (Pfizer). © 2019 Bristol Myers Squibb-Pfizer Inc. All rights reserved. Date of preparation: June 2019. Internal use only. Must not be shown to customers.