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Very low-dose anticoagulation in the form of rivaroxaban twice daily is a welcoming addition to the current antithrombotic arsenal in high-risk patients with acute coronary syndrome or stable coronary artery disease. Adequate patient selection in line with the entry criteria of the approval trials appears to be critical to avoid excessive bleeding.

Very low-dose direct oral anticoagulants combined with platelet inhibitors in coronary artery disease: ready for widespread use?