Combining Antiplatelet Drugs and Oral Anticoagulant Therapy in Atrial Fibrillation: Acute Coronary Syndromes and/or Percutaneous Coronary Intervention/Stenting Revisited

To the Editor:We agree with Gorelick1 that there is little evidence that combination aspirin and oral anticoagulant (OAC) therapy among patients with atrial fibrillation (AF) improves stroke prevention but, instead, increases risk of major bleeding. The latter should come as little surprise, given the mode of action of both drugs.Indeed, the efficacy of OAC compared with aspirin in this condition is overwhelmingly supported by data from clinical trials.2 However, AF commonly associates with (cardio)vascular disease, and frequently AF patients are still prescribed both OAC and antiplatelet therapies in combination. In the setting of …