Effect of aspirin in addition to oral anticoagulants in stable coronary artery disease outpatients with an indication for anticoagulation.

Antithrombotic management of outpatients with stable coronary artery disease (CAD) who also have an indication for long-term oral anticoagulation (OAC) is critical in daily practice, firstly because these patients are frequently seen, and secondly because they have shown a high risk of both ischemic events and bleeding as compared to patients without OAC. The current guidelines recommend that most of such patients should be treated with OAC alone (without any antiplatelet therapy) after 12 months of stability even when a stent has been implanted. Robust data are however very sparse and level of evidence very low to support such a strategy. The goal of the present manuscript is to review all available evidences to help the physician's choices in this specific context and to highlight the unsolved issues that should be addressed by new studies in the near future.