{"id":7234,"date":"2025-05-29T11:20:53","date_gmt":"2025-05-29T08:20:53","guid":{"rendered":"https:\/\/jordan-cardiac.org\/?p=7234"},"modified":"2025-05-29T11:20:53","modified_gmt":"2025-05-29T08:20:53","slug":"anticoagulation-vs-anticoagulation-plus-antiplatelet-in-af-stable-cad","status":"publish","type":"post","link":"https:\/\/jordan-cardiac.org\/en\/anticoagulation-vs-anticoagulation-plus-antiplatelet-in-af-stable-cad\/","title":{"rendered":"Anticoagulation vs Anticoagulation Plus Antiplatelet in AF + Stable CAD"},"content":{"rendered":"
\ud83d\udd0d Anticoagulation vs Anticoagulation Plus Antiplatelet in AF + Stable CAD<\/div>\n
<\/div>\n
Source: Journal of the American College of Cardiology (JACC), May 2025<\/div>\n
Title: Anticoagulation and Antiplatelet Therapy for Atrial Fibrillation and Stable Coronary Disease: Meta-Analysis of RCTs<\/div>\n
<\/div>\n
\ud83e\ude7a Background:<\/div>\n
<\/div>\n
Patients with atrial fibrillation (AF) and stable coronary artery disease (CAD) often require long-term antithrombotic therapy. The optimal strategy\u2014oral anticoagulation (OAC) alone vs OAC + single antiplatelet therapy (SAPT)\u2014has been debated.<\/div>\n
<\/div>\n
\ud83d\udcca Study Overview:<\/div>\n
\u2022 4 RCTs, 4,092 patients (mean age ~74, 20% women)<\/span><\/div>\n
\u2022 Agents used: DOACs (edoxaban, rivaroxaban), warfarin, aspirin, clopidogrel<\/span><\/div>\n
\u2022 Follow-up: Median 12\u201330 months<\/span><\/div>\n
<\/div>\n
\u2705 Key Findings:<\/div>\n
<\/div>\n
\ud83e\udde0 Effectiveness:<\/div>\n
\u2022 No significant difference in ischemic outcomes (MI, stroke, embolism, death) between:<\/span><\/div>\n
\u2022 OAC monotherapy vs OAC + SAPT<\/span><\/div>\n
<\/div>\n
\ud83e\ude78 Safety:<\/div>\n
\u2022 Major bleeding significantly lower with OAC alone (3.3% vs 5.7%; HR 0.59)<\/span><\/div>\n
\u2022 Clinically relevant bleeding also reduced (HR 0.53)<\/span><\/div>\n
\u2022 Bleeding benefit more pronounced in men and patients with diabetes<\/span><\/div>\n
<\/div>\n
\ud83d\udcd8 Guideline Alignment \u2013 ESC 2024 & ACC\/AHA 2023:<\/div>\n
<\/div>\n
Patients with \u201cAF and stable CAD\u201d (e.g. \u22651 year – post-PCI or or post ACS)should generally be treated with:<\/div>\n
\u2022 OAC monotherapy (e.g., apixaban, rivaroxaban)<\/span><\/div>\n
\u2022 Avoid antiplatelet therapy unless high ischemic risk.<\/span><\/div>\n
<\/div>\n
\ud83d\udccc Simplified Therapy Guide for AF Patients Undergoing PCI:<\/div>\n
<\/div>\n
\ud83d\udfe2 Elective PCI (Stable CAD):<\/div>\n
\u2022 Triple therapy (OAC + aspirin + clopidogrel): for 1 week post-elective PCI\u00a0<\/span><\/div>\n
\u2022 Dual therapy (OAC + clopidogrel): from week 1 to 6 months<\/span><\/div>\n
\u2022 OAC monotherapy: from 6 months onward, if no high ischemic risk<\/span><\/div>\n
<\/div>\n
\ud83d\udd34 ACS PCI (NSTEMI\/STEMI):<\/div>\n
\u2022 Triple therapy: for up to 1 month<\/span><\/div>\n
\u2022 Dual therapy: from month 1 to 12 months<\/span><\/div>\n
\u2022 OAC monotherapy: after 12 months, if clinically stable<\/span><\/div>\n
<\/div>\n
\u2705 Aspirin should be stopped early, and clopidogrel is preferred as the antiplatelet agent<\/div>\n
\u2705 DOACs are favored over warfarin for safety and convenience<\/div>\n
\u2705 Long-term goal: simplify to OAC monotherapy to reduce bleeding risk<\/div>\n
<\/div>\n
\ud83e\uddfe Conclusion:<\/div>\n
<\/div>\n
In patients with AF and stable CAD, OAC monotherapy is as effective as OAC + SAPT for preventing ischemic events and significantly safer regarding bleeding. Guidelines now support simplified, tailored therapy based on patient risk and timing after PCI or ACS.<\/div>\n
https:\/\/click.mail.medscape.com\/?qs=d2c53e22ac57c99e2928f769b7b8152fe546d6f7fdb590b367a833ac6b87709af0be488f3a188854f59cb7857b7a0a15e5540783217b23ad2d4322488a682ae7<\/a><\/div>\n","protected":false},"excerpt":{"rendered":"

\ud83d\udd0d Anticoagulation vs Anticoagulation Plus Antiplatelet in AF + Stable CAD Source: Journal of the American College of Cardiology (JACC), May 2025 Title: Anticoagulation and Antiplatelet Therapy for Atrial Fibrillation and Stable Coronary Disease: Meta-Analysis of RCTs \ud83e\ude7a Background: Patients with atrial fibrillation (AF) and stable coronary artery disease (CAD) often require long-term antithrombotic therapy. […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-7234","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/7234","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/comments?post=7234"}],"version-history":[{"count":1,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/7234\/revisions"}],"predecessor-version":[{"id":7235,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/7234\/revisions\/7235"}],"wp:attachment":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/media?parent=7234"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/categories?post=7234"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/tags?post=7234"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}