OAC Monotherapy Cuts Bleeding Without Ischemic Penalty in CCS
This meta-analysis consolidates six randomized trials supporting oral anticoagulant monotherapy over dual-pathway therapy in anticoagulated chronic coronary syndrome patients, refining long-term antithrombotic de-escalation for pharmacists.
OAC monotherapy reduces bleeding in CCS without adding ischemic risk.
Balancing thrombotic and bleeding risks in chronic coronary syndrome (CCS) is crucial for optimal patient outcomes. OAC monotherapy reduced net adverse clinical events (HR, 0.66) and major bleeding (HR, 0.47) compared to combination therapy. No significant difference was found in all-cause mortality. The study supports considering OAC monotherapy over combination therapy in CCS for reducing bleeding risk without increasing ischemic events. OAC monotherapy may offer a safer profile than combination therapy for anticoagulated CCS patients.
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Citation:Liang S, Chen X, Wang D, et al. Oral Anticoagulation Monotherapy vs Dual-Pathway Antithrombotic Therapy in Chronic Coronary Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis. 2026;32:10760296261476817. doi:10.1177/10760296261476817
Subscribers receive access to a complete clinical analysis, available online and as a downloadable PDF.
Executive Summary
Study Design
Patient Population
Primary Outcomes
Secondary Outcomes & Safety Profile
Pharmacist Implications
Clinical Pearls
Limitations
Controversies & Evidence Gaps
Cost & Logistics
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