Antithrombotic regimens in patients with atrial fibrillation and coronary disease: optimizing efficacy and safety.

Clear evidence supports the value of oral anticoagulation (OAC) with vitamin K antagonists in preventing stroke and thromboembolism in patients with atrial fibrillation (AF) who have well-established risk factors. For this indication, vitamin K antagonists have been shown to be superior to single or dual antiplatelet agents in reducing thromboembolic complications (1). Yet, up to 30% of patients with AF also have indications for antiplatelet therapy because of coronary artery disease (2). Dual antiplatelet therapy with aspirin and a P2Y12 receptor inhibitor (e.g., clopidogrel) is usually recommended after stent implantation or acute