- Oral anticoagulant (OAC) monotherapy and OAC plus single antiplatelet therapy (SAPT) showed similar efficacy in patients with non-valvular atrial fibrillation (Afib) and coronary artery disease (CAD).
- However, the risk for bleeding was significantly reduced with OAC monotherapy compared with OAC plus SAPT.
Why this matters
- Although guidelines recommend OAC monotherapy for patients with Afib and stable CAD of >1 year after myocardial infarction or percutaneous coronary intervention, there is limited evidence on their use.
- 6 studies (n=8855) that compared OAC monotherapy with OAC plus single SAPT for patients with stable CAD and non-valvular AF were identified.
- Primary outcome: major adverse cardiovascular events (MACEs; ischaemic or thrombotic events).
- Secondary outcomes: major bleeding, stroke, all-cause death and adverse events (ischaemic, thrombotic or bleeding events).
- Funding: None.
- No significant difference was observed in MACEs between OAC and OAC plus SAPT groups (HR, 1.09; 95% CI, 0.92-1.29; P=.309).
- Compared with OAC monotherapy, OAC plus SAPT group had a significantly higher risk for:
- major bleeding (HR, 1.61; 95% CI, 1.38-1.87; P<.001 and>
- adverse event (HR, 1.21; 95% CI, 1.02-1.43; P=.026).
- Treatment quality of vitamin K antagonist not evaluated in all studies.