Aspirin in Patients with Chronic Coronary Syndrome Receiving Oral Anticoagulation

MedicalResearch.com Interview with: [caption id="attachment_70865" align="alignleft" width="200"] Prof. Lemesle[/caption] Gilles Lemesle, M.D., Ph.D Lille University Hospital, Lille, France Guillaume Cayla, M.D., Ph.D Université de Montpellier, France Martine Gilard, M.D., Ph.D Hospital Cavale Blanche, Brest, France   MedicalResearch.com: What is the background for this study? Response: Patients with chronic coronary syndrome (CCS) and receiving long-term oral anticoagulation (OAC), mainly but not solely for atrial fibrillation, are at high risk of both atherothrombotic events on one side and bleeding events on the other side. Therefore, the optimal antithrombotic management for these patients with CCS requiring OAC after stenting is critical, especially in those patients at high residual atherothrombotic risk. Previous studies reported that in this specific context, the addition of antiplatelet therapy on top of OAC increases bleeding without a clear benefit on ischemic outcomes. Nevertheless, these studies presented several limitations, which restricted the applicability of their results in clinical pratice. They were indeed all open-labelled, included patients without stenting and/or at low atherothrombotic risk, and focused on Asian patients who have different atherothrombotic and bleeding risks as compared to Europeans. Thus, the rationale of the AQUATIC trial comes from the need to better identify the optimal antithrombotic regimen in high-risk patients with CCS and previous stenting, who receive long-term OAC, in order to optimize the atherothrombotic/bleeding risks in this population. The AQUATIC trial analyzed the efficacy and safety of adding aspirin to OAC, a combination that is still commonly used for this high-risk population in clinical daily practice.