Abstract

Antithrombotic treatment in patients with stable coronary artery disease and previous stent implantation who require long-term oral anticoagulation is a constant challenge in clinical practice, especially for patients who are at high risk for vascular and coronary events. Stopping aspirin in high-risk patients with chronic coronary syndrome after percutaneous coronary intervention may lead to recurrent ischemic events, whereas combination therapy with aspirin and oral anticoagulation may lead to a higher risk of bleeding. For decades, we thought the answer of combination therapy was superior to anticoagulation monotherapy. However, several clinical trials have shown evidence against this practice. This short communication provides an in-depth analysis of the AQUATIC clinical trial and its potential implications for the treatment of AF and CAD.

Key words: Chronic coronary syndrome; Aspirin; Direct oral anticoagulants; Clinical trial; Coronary artery disease; Percutaneous coronary intervention; Warfarin