Coronary disease & ACSMeta-analysis
Oral Anticoagulation With or Without Antiplatelet Therapy in Chronic Coronary Syndrome
- Systematic review and meta-analysis of randomised trials
- random-effects
Authors' conclusion
In patients with CCS requiring long-term OAC, OAC monotherapy was associated with reduced bleeding, cardiovascular death, and net adverse clinical events compared with OAC plus SAPT.
Study context
- Population
- Patients with chronic coronary syndrome requiring long-term oral anticoagulation (OAC)
- Participants
- 5,924 patients · 6 trials
- Comparison
- OAC monotherapy vs OAC plus single antiplatelet therapy (SAPT)
- Outcome
- Efficacy: trial-defined MACE; safety: any bleeding
Pooled result
MACE (primary efficacy)
Hazard ratio
0.85
95% CI 0.64–1.09
By group
OAC monotherapy vs OAC plus SAPT
HR 0.85 (95% CI 0.64–1.09)
As reported in the abstract
Further pooled results
| Outcome | HR (95% CI) | |
|---|---|---|
| CV death · I2 =0% | 0.69 (0.48–0.97) | |
| Net adverse clinical events · I2 =66% | 0.60 (0.47–0.78) | |
| 0.512Hazard ratio (log scale) |
MI, stroke, all-cause mortality
- No significant differences in MI, stroke or all-cause mortality
Safety
| Outcome | OAC monotherapy | OAC plus SAPT | HR (95% CI) | |
|---|---|---|---|---|
| Any bleeding (primary safety) · I2 =8% | 8.9% | 16.1% | 0.49 (0.44–0.55) | |
| Major bleeding · I2 =47% | 0.46 (0.32–0.66) | |||
| 0.20.5125Hazard ratio (log scale) |
Original publication
Oral Anticoagulation With or Without Antiplatelet Therapy in Chronic Coronary Syndrome. JACC Cardiovasc Interv. Published 25 May 2026. doi:10.1016/j.jcin.2026.03.020
Summarised from the published abstract; every number is checked against it