# Aspirin Plus Oral Anticoagulation in High-Risk Patients with Stable Coronary Artery Disease After Percutaneous Coronary Intervention Stenting: Important Lessons Learned from the AQUATIC Trial

## Authors

- Elfreda Dzukey ([ORCID](https://orcid.org/0000-0000-0000-0000)) — Department of Pharmacy, Campbell University College of Pharmacy & Health Sciences, Buies Creek, NC, USA
- Kevan English ([ORCID](https://orcid.org/0009-0006-8893-5696)) — Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA

## Article information

- **Journal:** The Ulutas Medical Journal (Ulutas Med J), ISSN 2149-388X
- **Issue:** Volume 12, Issue 1 (2026), pages 4–6
- **Article type:** Short Communication
- **Published online:** 2026-03-26
- **DOI:** [10.5455/umj.20260104053745](https://doi.org/10.5455/umj.20260104053745)
- **Licence:** [CC BY-NC 4.0](https://creativecommons.org/licenses/by-nc/4.0/)
- **Article page:** https://www.ulutasmedicaljournal.com/?mno=305478
- **PDF:** https://www.ulutasmedicaljournal.com/pdf/305478.pdf

## Abstract

Antithrombotic treatment in patients with stable coronary artery disease and previous stent implantation who require long-term oral anticoagulation is a constant challenge in clinical practice, especially for patients who are at high risk for vascular and coronary events. Stopping aspirin in high-risk patients with chronic coronary syndrome after percutaneous coronary intervention may lead to recurrent ischemic events, whereas combination therapy with aspirin and oral anticoagulation may lead to a higher risk of bleeding. For decades, we thought the answer of combination therapy was superior to anticoagulation monotherapy. However, several clinical trials have shown evidence against this practice. This short communication provides an in-depth analysis of the AQUATIC clinical trial and its potential implications for the treatment of AF and CAD.

## Keywords

Chronic coronary syndrome; Aspirin; Direct oral anticoagulants; Clinical trial; Coronary artery disease; Percutaneous coronary intervention; Warfarin

## How to cite

Dzukey E, English K. Aspirin Plus Oral Anticoagulation in High-Risk Patients with Stable Coronary Artery Disease After Percutaneous Coronary Intervention Stenting: Important Lessons Learned from the AQUATIC Trial. Ulutas Med J. 2026;12(1):4-6. doi:10.5455/umj.20260104053745

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