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The American College of Chest Physicians recommends that dual therapy with aspirin plus an oral anticoagulant (OAC) be reserved mainly for selected patients with mechanical prosthetic heart valves: those with caged ball or caged disk valves, those with systemic embolism despite a therapeutic INR, and those with an additional risk factor, such as atrial fibrillation. However, physicians frequently prescribe dual therapy to a wider group of patients. Researchers compared the safety and efficacy of treatment with an OAC alone and an OAC plus aspirin in a meta-analysis of 10 randomized controlled trials involving 4180 patients. The trials enrolled patients with mechanical heart valves (5 trials), atrial fibrillation (2), coronary artery disease…