Coronary disease & ACSMeta-analysis
Direct oral anticoagulant monotherapy vs combination therapy with antiplatelets in chronic coronary syndrome patients with prior percutaneous coronary intervention requiring anticoagulation: A meta-analysis
- meta-analysis of randomized trials
Authors' conclusion
In this meta-analysis of randomized trials, direct oral anticoagulant monotherapy significantly reduced major adverse cardiac and cerebrovascular events and major bleeding without increasing ischemic events. The benefit in major adverse cardiac and cerebrovascular events was driven primarily by reductions in all-cause and cardiovascular mortality, supporting a bleeding-avoidance strategy in this high-risk population.
Study context
- Population
- Chronic coronary syndrome patients with prior percutaneous coronary intervention requiring anticoagulation
- Comparison
- direct oral anticoagulant monotherapy compared with combination therapy with antiplatelets
Pooled result
As reported in the abstract
Major adverse cardiac and cerebrovascular events, major bleeding, ischemic events
- direct oral anticoagulant monotherapy significantly reduced major adverse cardiac and cerebrovascular events and major bleeding without increasing ischemic events
Further pooled results
Drivers of the benefit in major adverse cardiac and cerebrovascular events
- The benefit in major adverse cardiac and cerebrovascular events was driven primarily by reductions in all-cause and cardiovascular mortality
Original publication
Direct oral anticoagulant monotherapy vs combination therapy with antiplatelets in chronic coronary syndrome patients with prior percutaneous coronary intervention requiring anticoagulation: A meta-analysis. Am Heart J. Published 17 May 2026. doi:10.1016/j.ahj.2026.107492
Summarised from the published abstract; every number is checked against it