Can We Skip Aspirin After Coronary Stenting in Patients Taking Anticoagulants?

Some patients requiring chronic oral anticoagulation for atrial fibrillation or mechanical heart valves undergo coronary stenting and are subsequently given aspirin and clopidogrel — in addition to the anticoagulant — to prevent stent thrombosis. However, triple antithrombotic therapy carries an increased risk for bleeding.

In an open-label, European, multicenter trial, investigators randomized 573 adults taking anticoagulants (mean age, 70; 20% women) to receive clopidogrel alone (double therapy) or clopidogrel plus aspirin (triple therapy) after coronary stenting (radial access, 25%; bare-metal stents, approximately one third).

At 1-year follow-up, the primary outcome of any bleeding episode occurred in 19.4% of double-therapy recipients an…