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In patients with stable coronary disease who receive full-intensity oral anticoagulation for atrial fibrillation (AF), it can be unclear whether to add low-dose aspirin. Previous randomized trials suggested limited benefit from add-on aspirin, but it led to an excess in bleeding events; however, those trials were conducted in East Asia and exclusively enrolled patients who received anticoagulation only for AF. In a multicenter, double-blind randomized trial from France, investigators have now compared add-on aspirin with placebo in patients with chronic coronary syndrome who had undergone stenting >6 months before enrollment, had other high-risk features, and had an indication for full-intensity oral anticoagulation (89% had AF).
The trial w…