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After a common heart procedure, less medication may be just as safe — and easier on the body. The SIMPLAAFY trial found that single-drug therapy (either low-dose aspirin or a reduced-dose blood thinner) was just as effective as the standard two-drug regimen following left atrial appendage closure, while also cutting bleeding risk significantly.
After left atrial appendage closure (LAAC) — a procedure used to reduce stroke risk in patients with atrial fibrillation — doctors typically prescribe dual antiplatelet therapy (DAPT) to prevent clots while the device heals in place. But new data suggest that simpler, single-drug regimens work just as well, with fewer side effects.
The SIMPLAAFY trial, presented at TCT 2026 and published in JAMA, randomly assigned 1,857 patients to one of three post-LAAC regimens: 6-month DAPT, 3-month reduced-dose NOAC followed by aspirin, or 12-month aspirin alone. Both monotherapy arms met the bar for noninferiority against DAPT on the composite endpoint of death, stroke, systemic embolism, or major bleeding at 6 months — and both significantly reduced bleeding risk.
Key Takeaways:
Why it matters: These findings give clinicians a data-backed path to personalize post-LAAC care — balancing each patient's bleeding and clotting risks rather than defaulting to a one-size-fits-all approach.
