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Getting the latest healthcare news for you
Getting the latest healthcare news for you
For patients with stable chronic coronary syndrome (CCS) who need long-term blood thinners, skipping the add-on antiplatelet drug may be the safer play. A new meta-analysis found that anticoagulant monotherapy slashed major bleeding risk by 53% compared to combination therapy — without raising the risk of heart attacks or strokes. The findings back current European cardiology guidelines.
For patients with stable chronic coronary syndrome (CCS) who need long-term anticoagulation, adding an antiplatelet drug may do more harm than good. A meta-analysis of five randomized controlled trials — covering 5,777 patients — found that oral anticoagulation (OAC) monotherapy significantly outperformed combination therapy (OAC + antiplatelet) on bleeding outcomes, without any meaningful trade-off in cardiovascular protection.
The analysis, published in the European Journal of Preventive Cardiology, included patients on a range of anticoagulants — apixaban, dabigatran, edoxaban, rivaroxaban, and vitamin K antagonists — with follow-up periods ranging from 12 to 30 months. A subgroup analysis also suggested that patients on direct OACs (rather than vitamin K antagonists) saw even more favorable cardiovascular outcomes with monotherapy.
By the Numbers:
Why it matters: These findings provide robust evidence supporting current ESC guidelines that favor OAC monotherapy in stable CCS patients — reassuring clinicians that dropping the antiplatelet doesn't come at the cost of ischemic risk.
