Clinical Electrophysiology -> Atrial Fibrillation & Atrial Flutter: -> Pharmacology (Antiarrhythmic drugs and anticoagulants) D-PO02 - Poster Session II (ID 47) Poster

D-PO02-221 - Oral Anticoagulant Monotherapy Versus Single Antiplatelet Plus Oral Anticoagulant In Patients With Stable Coronary Artery Disease And Atrial Fibrillation- A Meta-analysis (ID 1067)


Background: Given increasing prevalence of patients with stable coronary artery disease (CAD) and atrial fibrillation (AF), questions regarding optimal single antiplatelet (SAPT) and oral anticoagulant (OAC) (both warfarin and direct oral anticoagulant) remain unanswered.
Objective: We sought to compare OAC vs OAC plus SAPT (aspirin or clopidogrel) in this patient population.
Methods: Comprehensive literature search was performed using Google Scholar, PubMed, and Cochrane Central Register of Controlled Trials. Two investigators independently extracted the data and individual quality assessment was performed. Baseline characteristics and clinical outcomes were extracted and analyzed. Random-effects model was used and pooled hazard ratios (HRs) are presented with 95% confidence interval (CI).
Results: 7 trials including 11,070 patients were included in the final analysis. OAC plus SAPT was associated with significantly higher risk of major bleeding [HR= 1.57, 95%CI 1.37-1.80] and net adverse events (composite of ischemic, thrombotic or bleeding events) [HR= 1.25, 95%CI 1.09-1.44] compared with OAC monotherapy. There was no significant difference in stroke [HR=1.04, 95%CI 0.78-1.39], all- cause death [HR=1.15, 95%CI 0.95-1.40] or major adverse cardiac event (MACE- a composite of ischemic or thrombotic events) [ HR= 1.09, 95%CI 0.92-1.30] among patients treated with OAC plus SAPT or OAT monotherapy alone.
Conclusion: Results of our meta-analysis indicate that OAC monotherapy is associated with lower risk of major bleeding and net adverse events as compared to OAC plus SAPT in patients with AF and stable CAD.