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CAD plus atrial fib: should we use aspirin plus anticoag?

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  A recent study found that aspirin was actually harmful in patients with chronic coronary syndrome who were at high atherothrombotic risk and were on long-term anticoagulation, in the AQUATIC trial (Assessment of Quitting versus Using Aspirin Therapy in Patients with Stabilized Coronary Artery Disease after Stenting Who Require Long-Term Oral Anticoagulation. a bit of a mouthful....) in this French study: see   aspirin plus anticoag NEJM2025  in dropbox, or DOI: 10.1056/NEJMoa2507532     -- "chronic coronary syndrome" is the new name for "stable coronary artery disease" Details : -- 872 adults were eligible who had documented chronic coronary syndrome with previous coronary stent implantation more than 6 months before enrollment, had features of high residual atherothrombotic risk, and were receiving an oral anticoagulant (either a direct oral anticoagulant DOAC or a vitamin K antagonist VKA) for any reason.     --inclusion criteria: high-ri...
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Atrial fib: caffeine decreases recurrences

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  another study highlighting benefit of caffeinated coffee, this time finding a decrease in recurrent atrial fibrillation after ablation (see   afib caffeine dec afib recurrence JAMA2026  in dropbox, or doi:10.1001/jama.2025.21056), in the DECAF study (Does Eliminating Coffee Avoid Fibrillation) Details : --  200 current or previous (within past 5 years) coffee-drinking adults with persistent atrial fibrillation (AF), or atrial flutter with a history of AF, planned for electrical cardioversion from 5 hospitals in the US, Canada, and Australia between November 2021 and December 2024 in this  prospective, open-label, randomized clinical trial. The date of final follow-up was June 5, 2025. -- all patients had planned upcoming direct current electrical cardioversion -- patients who had sustained successful cardioversion were randomized to 2 groups: one group had regular caffeinated coffee consumption, and the other group to abstain from coffee and caf...
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