Direct oral anticoagulants combined with antiplatelet in the treatment of acute coronary syndrome and atrial fibrillation patients undergoing percutaneous coronary intervention or complicating acute coronary syndrome: a systematic review and meta-analysis

The combination of DOACs and APT requires a tailored approach. For ACS patients, therapy should center on balancing ischemic and bleeding risks, favoring those at high ischemic risk but low or manageable bleeding risk. In contrast, for AF patients undergoing PCI or complicating ACS, the regimen is aimed at risk minimization and is most suitable for patients in whom this is the primary concern.Protocol registration: www.crd.york.ac.uk/prospero identifier is CRD42025645639.