Which Antithrombotic Strategy Is Best in AF Patients Hospitalized for Coronary Artery Disease?

A large Danish registry study suggests that dual anticoagulant–antiplatelet therapy is as effective as triple therapy including aspirin.

The main finding from this large observational study is that outcomes with a combination of an anticoagulant and clopidogrel are comparable to those of triple therapy with regard to ischemic endpoints as well as bleeding. Possibly more important are the findings that dual antiplatelet therapy alone was associated with increased rates of ischemic stroke and all-cause mortality, and anticoagulant–aspirin therapy with increased mortality. The findings support the results of a small trial (NEJM JW Cardiol Feb 27 2013) suggesting that the optimal regimen for stent recipients with atrial fibrillation is an anticoagulant plus clopidogrel.

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