The rst trial was the What Is the Optimal Antiplatelet and Anticoagulant Therapy in Patients With Oral Anticoagulation and Coronary Stenting which randomized 573 adults receiving OACs (65% with AF) and undergoing PCI to clopidogrel alone (double therapy) or clopidogrel plus aspirin (triple therapy). The primary end point of any bleeding was seen in 19.4% receiving double therapy and 44.4% receiving triple therapy (HR, 0.36; 95% CI, 0.26-0.50; P < .0001). Of the secondary end points, there was no increase in the rate of thrombotic events, but all- cause mortality was higher in the triple-therapy arm. This trial was underpowered for ef cacy and safety end points, and the primary end point of any bleeding was driven by minor bleeds given that triple therapy was mandated for 12 months. The duration of triple therapy was also addressed by the Intracoronary Stenting and Antithrombotic Regimen- Testing of a Six-Week Versus a Six-Month Clopidogrel Treatment Regimen In Patients With Concomitant Aspirin and Oral Anticoagulant Therapy Following Drug-Eluting Stenting (ISAR-TRIPLE) study,285 an RCT in 614 patients receiving OAC plus aspirin, randomized to either 6 weeks of clopidogrel therapy (n 307) or 6 months of clopidogrel therapy (n 307). The primary end point (composite of death, MI, de nite stent thrombosis, stroke, or Thrombolysis In Myocardial Infarction major bleeding at 9 months) occurred in 30 patients (9.8%) in the 6-week group compared with 27 patients (8.8%) in the 6-month group (HR, 1.14; 95% CI, 0.68-1.91; P .63). There were no signi cant differences for the secondary combined ischemic end point of cardiac death, MI, de nite stent thrombosis, and 95% CI, 0.43-2.05; P .87) or the secondary bleeding end point of Thrombolysis In Myocardial Infarction 95% CI, 0.64-2.84; P .44). 