Clinical Edge

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Combination of non–vitamin K antagonist oral anticoagulant plus single antiplatelet therapy equals no increased cardiac risk in AF patients

Key clinical point: Treatment of atrial fibrillation patients with a combination of non–vitamin K antagonist oral anticoagulant plus single antiplatelet therapy yielded no increase in risk of major adverse cardiac events.

Major finding: No differences in adverse cardiac events occurred in a comparison of triple antithrombotic therapy with dual antiplatelet therapy (DAPT) plus a vitamin K antagonist (VKA) vs. non–vitamin K antagonist oral anticoagulant (NOAC) plus single antiplatelet therapy (SAPT), with a hazard ratio 1.07, but clinically significant bleeding was lower in the NOAC plus SAPT patients (hazard ratio 0.56).

Study details: The data come from a meta-analysis of four randomized, controlled trials including 10,969 atrial fibrillation patients who underwent percutaneous coronary intervention.

Disclosures: The study received no outside funding. Lead author Dr. Capodanno disclosed relationships with Bayer, Daiichi Sankyo, AstraZeneca, and Sanofi Aventis.

Citation:

Capodanno D et al. J Am Heart Assoc. 2020 Aug 18. doi: 10.1161/JAHA.120.017212.