Daily Medical Update

Coronary Artery Disease & Antiplatelet Therapy

Friday, February 6, 2026

🔬 Practice-Changing Findings
Evidence from RCTs and meta-analyses published in the last 12 months.

1. Stent Choice in Diabetes: XIENCE vs. Abluminus

Lancet (2026) – Randomized Controlled Trial (3,032 patients)

Key Findings

  • Abluminus Sirolimus-eluting stent (SES) was inferior to XIENCE Everolimus-eluting stent (EES).
  • Higher target lesion failure (9.7% vs 6.2%) and target-vessel MI with SES.
  • Highlights persistent challenges in optimizing PCI outcomes for diabetics.

📋 Practice Implication: XIENCE remains the preferred standard for diabetic patients; newer balloon-drug transfer technologies (SES) showed inferior results.

2. Drug-Coated Balloons (DCB) for De Novo Lesions

Cardiovasc Ther (2026) – Meta-Analysis (28,292 patients)

Key Findings

  • DCB is a safe alternative to DES with comparable MACE and superior late lumen loss reduction.
  • Benefits particularly pronounced in small vessel disease.
  • Supports shorter DAPT durations in appropriate patients.

📋 Practice Implication: Consider DCB for small vessel de novo CAD, especially when abbreviated DAPT is a priority.

3. OAC Monotherapy vs. Combination in Stable CAD

Expert Opin Pharmacother (2025) – Meta-Analysis

Key Findings

  • OAC monotherapy (especially DOACs) reduces major bleeding by ~51%.
  • Reduced cardiovascular death (RR 0.72) compared to OAC + antiplatelet.
  • Net clinical benefit favors OAC monotherapy without increasing ischemic risk.

📋 Practice Implication: In patients with stable CAD and AFib, DOAC monotherapy is the preferred long-term antithrombotic strategy.

4. Abbreviated APT (1-month) in HBR and CKD

EuroIntervention (2025) – MASTER DAPT Sub-analysis

Key Findings

  • 1-month APT is safe for High Bleeding Risk (HBR) patients regardless of CKD status.
  • Reduced major bleeding (BARC 2, 3, or 5) without increasing MACCE.

📋 Practice Implication: CKD status should not preclude the use of abbreviated 1-month antiplatelet therapy in patients at high bleeding risk.

📊 Additional Notable Studies

💡 Summary

Recent evidence favors de-escalation strategies: OAC monotherapy for stable CAD/AFib and abbreviated 1-month DAPT for high-bleeding-risk patients, including those with CKD. DCBs are increasingly validated for small vessel disease, while XIENCE remains the preferred stent standard for diabetics.

Generated from 149 PubMed abstracts · RCTs and Meta-analyses only

Next topic: Congestive Heart Failure (HFpEF vs HFrEF management)