 Prevention of recurrent cardiac ischemia in an ACS patient, necessitating APT. There is some evidence for using DAPT for beyond 12 months in non-AF patients from the DAPT and Prevention of Cardiovascular Events in Patients With Prior Heart Attack Using Ticagrelor Compared to Pla- cebo on a Background of Aspirin-Thrombolysis in Myocardial Infarction 54 (PEGASUS-TIMI 54) trials, to reduce nonstent-related ischemic and stroke events, but at the risk of more bleeding  Serious bleeding risks (eg, ICH) with the combination of OAC and one or more antiplatelet drug. Additional considerations are the duration of treatment, acute or stable setting, type of APT, stent type, OAC type, bleeding risks, etc. Bleeding risk can be assessed by various bleeding risk scores, with the focus on modi able bleeding risk factors; however, the HAS- BLED score is predictive of bleeding in the setting of ACS and/or PCI-stenting.109 Coronary stent technology has also evolved, with small strut sizes necessitating shorter duration of DAPT (ie, aspirin plus a P2Y12 inhibitor such as clopidogrel). We are also in the era of NOACs, which may offer a better safety pro le compared with VKA-based therapy. Nonetheless, the latter may be relatively safe in the presence of well- managed anticoagulation control with high TTR.279 AF Patients Undergoing PCI: Various case series and cohort studies of AF patients undergoing PCI/stenting have been reported. These have been systematically reviewed as part of the 2014 and 2018 joint European consensus documents, endorsed by the Heart Rhythm Society and the Asia-Paci c Heart Rhythm Society, which provides consensus recommendations on optimal management of such patients.92,277 A similar North American expert consensus document has been O O C O O O C O Dual therapy with OAC plus inhibitor up to 12 mo. Triple therapy up to if possible. A. 