The coexistence of
atrial fibrillation and
coronary artery disease is commonly found in clinical practice. The aim of this meta-analysis is to compare the clinical efficacy and safety of dual versus single antiplatelet
therapy in combination with antithrombotic
therapy in patients with
atrial fibrillation undergoing
percutaneous coronary intervention. PubMed, EMBASE and Web of Science databases were systematically evaluated for articles published up to October 31, 2017. The risk ratios (RR) were extracted from each study. Pooled estimates with corresponding 95% confidence intervals (CI) were estimated by a fixed or random-effects model. Eight studies involving a total of 10,861 patients with
atrial fibrillation were included in this meta-analysis. Five thousand sixty-six participants received dual antiplatelet
therapy together with
warfarin or new oral anticoagulation (triple antithrombotic
therapy, TT) and 5,795 participants received single antiplatelet
therapy together with
warfarin or new oral anticoagulation (dual antithrombotic
therapy). TT was associated with a significantly higher incidence of all (RR 1.45, p <0.001) and major (RR 1.77, p <0.001)
bleeding events, but no difference with regard to
stroke, in-
stent thrombosis, major adverse cardiovascular events, and all-cause mortality rate. In conclusion, as compared to TT, dual antithrombotic
therapy is equally effective in reducing
stroke, in-
stent thrombosis, major adverse cardiovascular events, and all-cause mortality rate, but shows beneficial effect in reducing overall
bleeding incidence in
atrial fibrillation patients who underwent
percutaneous coronary intervention.