1. Adding aspirin to oral anticoagulation in patients with chronic coronary syndrome and prior stent implantation did not reduce ischemic events.
2. Combination therapy was associated with higher cardiovascular and all-cause mortality compared with anticoagulation alone.
3. Major bleeding occurred nearly three times more often in the aspirin group (10.2% vs 3.4%).
4. The AQUATIC trial was stopped early after a median of 2.2 years due to excess deaths in the aspirin arm.
5. Monotherapy with oral anticoagulation should remain the standard in stable, high-risk post-stent patients to balance thrombosis prevention with bleeding safety.

Source: The New England Journal of Medicine