January 27, 2014Circulation287 citationsOpen Access
View Full PaperAntiplatelet Therapy for Stable Coronary Artery Disease in Atrial Fibrillation Patients Taking an Oral Anticoagulant
Structured PICO
Does the addition of antiplatelet therapy to VKA therapy reduce recurrent coronary events or thromboembolism in atrial fibrillation patients with stable coronary artery disease?
P
Population
Atrial fibrillation patients with stable coronary artery disease taking an oral anticoagulant (vitamin K antagonist)
I
Intervention
Addition of antiplatelet therapy to vitamin K antagonist (VKA) therapy
C
Comparator
Vitamin K antagonist (VKA) therapy alone
O
Outcome
Recurrent coronary events or thromboembolismhard clinical
Adding antiplatelet therapy to VKA anticoagulation in AF patients with stable CAD increases bleeding risk without reducing coronary or thromboembolic events, suggesting this common practice should be reassessed.
Abstract
In atrial fibrillation patients with stable coronary artery disease, the addition of antiplatelet therapy to VKA therapy is not associated with a reduction in risk of recurrent coronary events or thromboembolism, whereas risk of bleeding is increased significantly. The common practice of adding antiplatelet therapy to oral VKA anticoagulation in patients with atrial fibrillation and stable coronary artery disease warrants reassessment.