A streamlined anticoagulation protocol combining a P2Y12 inhibitor with direct oral anticoagulants demonstrated a 23% reduction in major bleeding events among atrial fibrillation patients requiring coronary stents, compared to traditional triple therapy approaches. The dual-drug regimen maintained equivalent protection against thrombotic events while significantly lowering hemorrhagic complications across a cohort of 4,200 participants followed for median 18 months. This finding addresses a persistent clinical dilemma where patients need both stroke prevention from atrial fibrillation and clot prevention around newly implanted stents. Traditional triple therapy—combining aspirin, clopidogrel, and warfarin—has long carried substantial bleeding liability, particularly gastrointestinal and intracranial hemorrhage. The simplified approach represents meaningful progress for the growing population managing both cardiovascular conditions simultaneously, especially older adults where bleeding risks compound with age-related physiological changes. While the study's relatively short follow-up period requires longer-term validation, the magnitude of bleeding reduction without compromising efficacy suggests this protocol could become standard care. The approach particularly benefits patients over 75 or those with prior bleeding history, populations traditionally considered high-risk for multiple anticoagulation strategies.