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Abstract How to determine the antithrombotic strength in patients with atrial fibrillation (AF) complicating stable coronary artery disease (SCAD) after one year has always been a clinical challenge and a controversial issue. In the past, most of these people were considered to take longterm single anticoagulation, however the related evidencebased medicine evidences were not sufficient. At present, it is recommended that individualized and accurate management should be performed according to the risk stratification of ischemia and bleeding. Not only should the embolization score of AF be evaluated, but the complexity of the coronary artery disease should also be evaluated. The CHA2DS2VASc, SYNTAX Ⅱ and DAPT scores should be combined to comprehensively assess the ischemic risk of individuals while the HASBLED or BARC score should be combined to assess the bleeding risk for antithrombotic stratified management and dynamic evaluation. Anticoagulation combined with antiplatelet dual pathway inhibition can be given to the population with high ischemia risk and low bleeding risk. Longterm single anticoagulant therapy is suggested to be given to the population with low ischemia risk and high bleeding risk. This article mainly discusses the optimal antithrombotic strategy for patients with AF complicating SCAD after one year.
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