INTRODUCTION
thrombosis, death, bleeding, NVAF, nonvalvular atrial fibrillation, ACS
THROMBOSIS, BLEEDING
Dual antiplatelet therapy (DAPT) with aspirin and adenosine diphosphate (ADP) antagonist has been recommended for patients after drug‐eluting stent (DES) implantation to prevent stent thrombosis (recommendation level: IA),The new‐generation DES with better biocompatibility or biodegradable polymers or non‐polymer has been widely used in clinical practice. Compared with the first‐generation DES, the new‐generation DES is associated with faster endothelialization and lower incidence of stent thrombosis and is therefore less dependent on DAPT.The Platelet Inhibition and Patient Outcomes (PLATO) trial has found that in ACS patients, ticagrelor significantly decreased cardiovascular death by 21.6% compared with clopidogrel while being used in combination with aspirin.Our OPtimal management of anTIthroMbotic Agents (OPTIMA)‐4 trial is designed to test the hypothesis that, for ACS patients with concomitant nonvalvular atrial fibrillation (NVAF) and having low‐to‐moderate risk of bleeding, clopidogrel is comparable in efficacy but superior in safety compared to ticagrelor while being used in combination with dabigatran after new‐generation DES implantation.