Abstract
Atrial fibrillation (AF) and stable coronary artery disease (CAD) often coexist, creating a significant burden. The efficacy of adding antiplatelet therapy to oral anticoagulant (OAC) therapy in treating these patients remains unclear, prompting this meta-analysis. A comprehensive search across databases was conducted for relevant studies. Outcomes of interest included net adverse clinical event (NACE), all-cause mortality, cardiovascular disease (CVD) mortality, major bleeding, any bleeding, hemorrhagic stroke, and ischemic stroke. A hazard ratio (HR) with 95% confidence intervals (CI) was pooled. Three randomized controlled trials (3945 patients) were analyzed. OAC monotherapy (MT) significantly reduced major bleeding (HR: 0.57; 95% CI: 0.40-0.83; P = 0.003) and any bleeding (HR: 0.55; 95% CI: 0.46-0.65; P < 0.0001) compared to combination therapy. No significant findings were observed for NACE, all-cause mortality, CVD mortality, hemorrhagic and ischemic strokes. Our meta-analysis revealed that OAC MT significantly reduced bleeding events while the number of stroke events and mortality remained similar compared to combination therapy in patients with AF and stable CAD.