The AUGUSTUS trial was published in 2019 (7) and was designed as a two-by-two factorial RCT evaluating the safety and efficacy of omitting aspirin with both VKA and apixaban, against a background of combining P2Y12 inhibitor (most commonly clopidogrel) treatment for 6 months in 4,614 AF patients with a recent ACS event or undergoing PCI (Figure 1) (20). This evidence concerns the gene P2RY12 and atrial fibrillation.