Key result
Cochrane protocol outlines planned review comparing oral anticoagulant monotherapy versus combination therapy in stable CAD.
Why the study?
The benefits and harms of oral anticoagulant monotherapy compared with oral anticoagulant plus antiplatelet therapy in adults with stable coronary artery disease requiring long-term anticoagulation are uncertain.
Does oral anticoagulant monotherapy reduce major bleeding and ischaemic events compared with oral anticoagulant plus antiplatelet therapy in adults with stable coronary artery disease requiring long-term anticoagulation?
Systematic Review
Does oral anticoagulant monotherapy reduce major bleeding and ischaemic events compared with oral anticoagulant plus antiplatelet therapy in adults with stable coronary artery disease requiring long-term anticoagulation?
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“The most striking finding was that this benefit was accompanied by no apparent ischemic penalty, even after inclusion of newer trials enrolling patients at relatively high atherothrombotic risk.... That is important because one of the main reasons many clinicians continue single antiplatelet therapy beyond 1 year is concern about late-occurring ischemic events.”
“There is no benefit in terms of atherothrombotic events, and it harms a lot in terms of bleeding and death.”
“The precision of the estimate is so good now that basically [we know] there is only harm in using two [agents] at the same time.”
This protocol outlines a Cochrane systematic review aiming to evaluate the benefits and harms of oral anticoagulant monotherapy versus oral anticoagulant plus a single antiplatelet agent in adults with stable coronary artery disease requiring long-term anticoagulation.
OBJECTIVES: This is a protocol for a Cochrane review (intervention). The objectives are as follows: To assess the benefits and harms of oral anticoagulant monotherapy compared with oral anticoagulant plus antiplatelet therapy in adults with stable coronary artery disease requiring long-term anticoagulation.
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Kim et al. (2026) conducted a systematic review in stable coronary artery disease requiring long-term anticoagulation. Oral anticoagulant monotherapy vs. Oral anticoagulant plus a single antiplatelet agent was evaluated on All-cause mortality, major bleeding, and composite ischaemic outcome. This article is a protocol for a Cochrane review designed to assess the benefits and harms of oral anticoagulant monotherapy compared with combination therapy in stable coronary artery disease.
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