Objective
to assess whether adding aspirin to long-term oral anticoagulation improves outcomes in high-risk chronic coronary syndrome patients with prior stenting
Study
multicentre, randomised, double-blind, placebo-controlled trial
Population
patients with chronic coronary syndrome and prior stenting (>6 months), at high atherothrombotic risk requiring long-term oral anticoagulation
Endpoints
primary efficacy endpoint: composite of cardiovascular death, myocardial infarction, stroke, systemic embolism, coronary revascularisation and acute limb ischaemia; primary safety endpoint: bleeding
Conclusion
In CCS patients at high atherothrombotic risk, adding aspirin to oral anticoagulation increased major cardiovascular events, mortality and major bleeding.
Lemesle et al. NEJM. 2025 Aug 31.