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The following is a summary of “Meta-Analysis Comparing Oral Anticoagulant Monotherapy Versus Dual Antithrombotic Therapy in Patients With Atrial Fibrillation and Stable Coronary Artery Disease,” published in the October 2024 issue of Cardiology by Ahmed et al.
Patients with atrial fibrillation (AF) frequently require oral anticoagulants (OACs) for management, while antiplatelet agents are commonly used in coronary artery disease (CAD).
Researchers conducted a prospective study to compare the clinical outcomes of OAC monotherapy and dual antithrombotic therapy in patients with AF and stable CAD.
They searched significant databases, including PubMed/MEDLINE, Cochrane Library, and Embase (September 1, 2024), to identify RCTs that compared OAC monotherapy with dual antithrombotic therapy in patients with AF and stable CAD.
The results showed 3 RCTs reported data for 3,945 patients with AF and stable CAD, OAC monotherapy was associated with a significantly reduced relative risk of major bleeding (RR: 0.55, 95% CI: 0.32–0.95) compared to dual therapy. The risks of all-cause death (RR: 0.85, 95% CI: 0.49–1.48), cardiovascular death (RR: 0.84, 95% CI: 0.50–1.41), any stroke event (RR: 0.74, 95% CI: 0.46–1.18), and myocardial infarction (RR: 1.57, 95% CI: 0.79–3.12) were comparable across the 2 groups.
They concluded that OAC monotherapy significantly reduced the risk of significant bleeding while maintaining similar rates of ischemic events and mortality compared to dual antithrombotic therapy in patients with AF and stable CAD.
Source: onlinelibrary.wiley.com/doi/full/10.1002/clc.70026
