Abstract: Objective To compare the efficacy and safety of double antiplatelet treatment strategy (DAPT, aspirin, clopidogrel) and triple antiplatelet strategy (aspirin, clopidogrel and warfarin) in patients with oral anticoagulants (OAC). Methods PubMed, Cochrane and Embase database were searched, and the information from January 1966 to April 2016 was collected. The efficacy and safety of antithrombotic drugs in patients with OAC were compared. At the same time, supplemented data searched by hand were collected and included into references. RevMan 5.1 software was used in this Meta analysis. The primary endpoint events were all cause mortality, and the secondary endpoints included ischemic stroke, major bleeding events, myocardial infarction and in- stent thrombus formation. Results A total of 16 studies including 7 083 patients (triple antiplatelet treatment 3 330, double antiplatelet treatment 3 753) in this analysis. The median followup period was 1.6 years, and the average age was 73.2 years. Meta analysis showed that there was no significant difference in all cause mortality rate between dual antiplatelet strategy and triple antithrombotic strategy [OR（95%CI) =0.94（0.79-1.13)， P=0.54] , no significant difference in myocardial infarction incidence rate [OR（95%CI） =1.21（0.92-1.59)， P=0.16], and no significant difference in in-stent thrombosis events between dual antiplatelet strategy and triple antithrombotic strategy [OR （95%CI） =1.02（0.55-1.90)， P=0.94]. Compared with dual antiplatelet strategy for patients, the triple antithrombotic strategy can significantly reduce the risk of ischemic stroke [OR（95%CI)=0.44（0.30-0.63)， P＜0.001], and increase major bleeding events [OR（95%CI） =1.31（1.07-1.61)， P=0.008]. Conclusion In review of the application of OAC and DAPT in patients with indications of the anti thrombosis strategy, triple antithrombotic strategy can reduce the risk of stroke, and increase the risk of bleeding.

Key words: angioplasty, transluminal, percutaneous coronary, platelet aggregation inhibitors, stroke, hemorrhage, Meta-analysis, triple antithrombosis, double antithrombosis