Clinical Considerations Prior to Transition From Triple Antithrombotic Therapy to Dual Antithrombotic Therapy

To the Editor We read with great interest the publication by Lopes et al¹ regarding the network meta-analysis assessing antithrombotic treatment in patients with atrial fibrillation (AF). The authors used a bayesian network meta-analysis to compare the efficacy and safety of dual antithrombotic therapy (DAT) with triple antithrombotic therapy with respect to vitamin K antagonist (VKA) anticoagulants vs non-VKA anticoagulants. The study concluded that in patients with AF undergoing percutaneous coronary intervention (PCI), a non-VKA and P2Y₁₂ inhibitor vs VKA and dual antiplatelet therapy is associated with a lower incidence of bleeding (odds ratio, 0.49; 95% CI, 0.30-0.82) and a similar rate of ischemic outcomes (odds ratio, 1.02; 95% CI, 0.71-1.97).¹