One Drug Is Enough: Edoxaban Alone Beats Dual Therapy in AF–CAD, Even with Impaired Kidneys

EPIC‑CAD: Edoxaban Monotherapy by Renal Function Renal dysfunction simultaneously amplifies thrombotic and bleeding risk in atrial fibrillation (AF), complicating antithrombotic decisions in patients with co‑existing stable coronary artery disease (CAD). In this prespecified analysis of the randomized EPIC‑CAD trial (N = 1,040), patients with AF and chronic stable CAD were assigned to edoxaban monotherapy versus dual therapy (edoxaban plus a single antiplatelet agent) and then stratified by creatinine clearance into low (<50 mL/min; n = 252, 24.2%) and high (≥50 mL/min; n = 788, 75.8%) renal function.

Over 12 months , low‑CrCl patients—who were older and more comorbid—had significantly higher risks of net adverse clinical events ( NACE: all‑cause death, myocardial infarction, stroke/systemic embolism, urgent revascularization, or major/clinically relevant non‑major bleeding; HR 1.72; P…