Lopes RD, et al. - In an international trial with a two-by-two factorial design involving 4614 patients, researchers evaluated the independent impact of anticoagulant and antiplatelet therapy in patients with atrial fibrillation and recent acute coronary syndrome or percutaneous coronary intervention (PCI) planning to receive a P2Y₁₂ inhibitor. For this investigation, patients with atrial fibrillation were randomly assigned who had an acute coronary syndrome or had undergone PCI and were planning to take a P2Y₁₂ inhibitor to receive apixaban or a vitamin K antagonist and to receive aspirin or matching placebo for 6 months. According to findings, an antithrombotic regimen including apixaban, without aspirin, resulted in less bleeding and fewer hospitalizations with no significant differences in the incidence of ischemic events than regimens that included a vitamin K antagonist, aspirin, or both in patients with atrial fibrillation and a recent acute coronary syndrome or PCI treated with a P2Y₁₂ inhibitor.