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The optimal long-term antithrombotic strategy for patients with atrial fibrillation (AF) and concomitant coronary artery disease (CAD) following percutaneous coronary intervention (PCI) remains a key issue in cardiovascular disease. Historically, combination therapy, comprising oral anticoagulation (OAC) with antiplatelet agents, was considered the default strategy to mitigate ischaemic events in these high-risk populations. However, the substantial bleeding risk associated with triple antithrombotic therapy (warfarin plus dual antiplatelet therapy) led to a paradigm shift to dual antithrombotic therapy (DAT) based on direct oral anticoagulants (DOACs).