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

Am Heart JPublished

  • 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