Atrial Fibrillation and Stable Coronary Artery Disease — What Is the Optimal Anticoagulation–Antiplatelet Regimen?

In patients with atrial fibrillation (AF) and stable coronary artery disease (CAD), the tradeoff between ischemic risk reduction and bleeding risk is a delicate balance. Although patients with AF clearly require both antiplatelet therapy and anticoagulation in the short term after percutaneous coronary intervention (PCI) or after medically managed acute coronary ischemic events, is dual antithrombotic therapy beneficial later? In an industry-sponsored, randomized trial from South Korea (EPIC-CAD), published in 2024, researchers addressed this relatively common scenario.

Investigators compared edoxaban monotherapy with edoxaban plus antiplatelet agent (aspirin or clopidogrel) in patients with AF who had undergone PCI at least 6 months previou…