Fatima Eltyeb Hago: Are We Doing More Harm Than Good with Combination Antithrombotic Therapy in AF?
Fatima Eltyeb Hago, Clinical Pharmacist at Dr. Sulaiman AL Habib Medical Group, shared on LinkedIn:
”Are we doing more harm than good with combination antithrombotic therapy in our AF patients?
In anticoagulated patients with atrial fibrillation, antiplatelet therapy should be the exception not the rule.
41% reduction in major bleeding with OAC alone vs. combination therapy .
(Gargiulo et al., JACC 2026 – meta-analysis of 4 RCTs, 4,092 patients)
45% of APT users in post-acute long-term care settings have no clear indication .
(Ko et al., JAMA Internal Medicine 2024)
Yet aspirin and P2Y12 inhibitors continue to be prescribed alongside anticoagulation with no reassessment, no stop dates, and no clear rationale.
This 2026 guide from the Anticoagulation Forum gives us the framework to act , verify the indication, assess the timing, and make a clear clinical decision: (deprescribe, monitor, or continue) with a defined plan.”
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