Oral anticoagulant (OAC) monotherapy vs. dual-antithrombotic therapy (DAT) in patients with atrial fibrillation and coronary artery disease; a meta-analysis of four randomized controlled trials.

• Tác giả: Muhammad Abdullah, Muhammad Shuaib Abid, Ayesha Batool, Iftikhar Ali Ch, Anum Touseef Hussain, Hammad Ahmad Iftikhar, Minahil Iqbal, Salman Khalid, Uzair Majeed, Humza Saeed, Yusuf Ali Shah, Sufyan Shahid, Naeem Khan Tahirkheli, Muzaffar Ali Zahidi, Mishal Zehra
• Ngôn ngữ: eng
• Ký hiệu phân loại: 373.236 Lower level
• Thông tin xuất bản: England : Annals of medicine and surgery (2012) , 2025
• Bộ sưu tập: NCBI
• ID: 725220

Tóm tắt

 BACKGROUND: Dual-antithrombotic therapy (DAT) is recommended for patients with atrial fibrillation (AF) and stable coronary artery disease (CAD) but carries an increased risk of bleeding. Recent trials suggest oral anticoagulant (OAC) monotherapy as a safer alternative, but data remains limited. We conducted a meta-analysis to compare OAC monotherapy with DAT in this population. METHODS: A comprehensive literature search was conducted using PubMed, Embase, and Cochrane Central Library to identify randomized controlled trials (RCTs) that compared OAC monotherapy with DAT in patients with AF and stable CAD. A bivariate random-effects model was used to perform meta-analyses. Statistical analyses were conducted using R Software 4.4.1, with a significance level of RESULTS: Four RCTs with a total of 4123 patients (20.2% females) were included. The mean age of the participants was 74 years. The results showed a significant reduction in major or clinically relevant nonmajor bleeding (risk ratio [RR]: 0.52
  95% confidence interval [CI]: 0.34-0.80
  CONCLUSIONS: In patients with AF and stable CAD, OAC monotherapy reduced the risk of major bleeding, with no significant differences in NACE, major ischemic events, or all-cause mortality as compared to DAT.