Key result
Anticoagulant monotherapy >1 year post-PCI in AF shows similar bleeding and MACE risks versus dual therapy.
Why the study?
Guidelines recommend anticoagulant monotherapy rather than dual therapy with an antiplatelet drug beyond 1 year after PCI in patients with AF, but the risks and benefits remained uncertain.
Does anticoagulant monotherapy compared to dual therapy improve bleeding or ischemic outcomes in patients with atrial fibrillation beyond 1 year after PCI?
Cohort (n=3,331)
Yes
Does anticoagulant monotherapy compared to dual therapy improve bleeding or ischemic outcomes in patients with atrial fibrillation beyond 1 year after PCI?
Effect estimate: HRw 0.90 for bleeding, HRw 1.04 for MACE (95% CI 0.75-1.09 for bleeding, 0.90-1.19 for MACE)
In patients with atrial fibrillation beyond 1 year after PCI, anticoagulant monotherapy is associated with similar risks of bleeding and MACE compared to dual therapy, supporting current guideline recommendations.
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Anticoagulant monotherapy was associated with similar bleeding and MACE risks versus dual therapy beyond 1 year post-PCI in AF; leaves open optimal regimen pending randomized trials.
Jensen et al. (2022) conducted a cohort in Atrial fibrillation after percutaneous coronary intervention (n=3,331). Anticoagulant monotherapy vs. Dual therapy (anticoagulant and antiplatelet drug) was evaluated on Hospitalization for bleeding and major adverse cardiac events (MACEs) (HRw 0.90 for bleeding, HRw 1.04 for MACE, 95% CI 0.75-1.09 for bleeding, 0.90-1.19 for MACE). Anticoagulant monotherapy beyond 1 year post-PCI in atrial fibrillation patients had similar risks of bleeding hospitalization (HRw 0.90; 95% CI 0.75-1.09) and MACE compared to dual therapy.
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