Safety and efficacy of double vs. triple antithrombotic therapy in patients with atrial fibrillation with or without acute coronary syndrome undergoing percutaneous coronary intervention： a systematic review and meta-analysis of vitamin k antagonist a

Objective: To compare the safety and efficacy of double therapy (DT) (no aspirin) versus triple (TT) (with antithrombotic drugs in patients with atrial fibrillation acute coronary syndrome or underwent percutaneous intervention (PCI).Methods: We searched PubMed, Cochrane, Scopus, Web Science for relevant articles from inception to December 2020. conducted analysis dichotomous outcomes using risk ratio (RR) relative 95% confidence interval (CI), while continuous were analyzed mean difference (MD) CI. Heterogeneous random-effects model, homogeneous data fixed-effects model. assessed bias among included studies by Cochrane’s tool.Results: A total five included. Regarding Major Minor Bleeding, overall was significantly lower DT group compared TT (RR=0.60 [0.45, 0.81], (P = 0.07)). For endpoint (TIMI major minor bleeding, TIMI bleeding) favored over group, respectively 0.07)); (RR= 0.55 [0.43, 0.70], < 0.01)). Intracranial hemorrhage did not differ between both groups (RR=0.62 [0.37, 1.05], The endpoint, all-cause death showed no significant (RR=1.08 [0.89, 1.31], 0.42)). There differences two cardiovascular death, stent thrombosis, myocardial infarction stroke, (RR=1.10 [0.86, 1.41], 0.43); (RR=1.40 [0.92, 2.12], 0.11); (RR=1.20 [0.98, 1.49], 0.08); (RR=0.95 [0.66, 1.37], 0.79).; respectively).Conclusion: Compared therapy, is associated bleeding risks, including but incidence endpoints similar groups. Â