Atrial Fibrillation and Stable Coronary Artery Disease

Patients with atrial fibrillation are at high risk for stroke, and international guidelines recommend oral anticoagulant therapy. In patients with stable vascular disease without atrial fibrillation, antiplatelet therapy is recommended. However, atrial fibrillation commonly coexists with vascular diseases, such as coronary artery disease. When patients with both conditions present with an acute coronary syndrome or need to undergo percutaneous coronary intervention for implantation of a stent, management with oral anticoagulant therapy plus antiplatelet therapy is clearly supported by evidence from randomized trials. However, the evidence base is less clear for patients with atrial fibrillation and stable vascular disease. The clinician . . .