AMSTERDAM—Whether triple anti-thrombotic therapy should be accepted as generally the optimal approach for treating patients at high risk of having a myocardial infarction was scrutinised in a debate at the 2013 annual congress of the European Society of Cardiology here. Professor Harvey White from the University of Auckland in New Zealand and Dr Rikke Sørensen from Copenhagen University Hospital examined whether triple anti-thrombotic therapy could be too much of a good thing. While Dr JM Ten Berg from St Antonius Hospital, Nieuwegein, the Netherlands and Professor Robert Storey from Sheffield University in England raised the question of whether it could be possible to drop the use of aspirin altogether. Co-chairing the discussions — along with Dr Robert Giugliano, from Boston — was Professor John Camm of St George’s University of London. Peter Goodwin asked him how much the novel oral anti-coagulants have contributed to changing the outlook for anti-thrombotic therapy.