More blood thinners aren’t automatically better, another study confirms.
A new publication in JAMA Internal Medicine focuses on the minimal benefits and worrisome drawbacks of combining a daily aspirin with a drug from the new class of anticoagulants which includes apixaban, dabigatran, edoxaban and rivaroxaban.
The patients were taking one of these direct oral anticoagulants called DOACs to prevent stroke due to non-valvular atrial fibrillation or for the treatment of venous thromboembolism (deep vein thrombosis or pulmonary embolism). The included patients had no other reason for taking aspirin, such as a recent history of heart attack or a history of heart valve replacement. The researchers found that nearly a third of people who were prescribed a DOAC were also taking aspirin for no clear reason for aspirin.
“Patients on combination therapy were more likely to have bleeding episodes, but they were no less likely to have a blood clot,” says senior author Jordan Schaefer, MD, assistant professor of internal medicine and hematologist at Michigan Medicine, the researcher. University of Michigan Medical Center. “Therefore, it is important for patients to ask their doctors if they should take aspirin when prescribed a direct oral anticoagulant.”
The combination of an anticoagulant and an antiplatelet may be appropriate for people who have had a recent heart attack, recent coronary stent placement or bypass surgery, previous mechanical valve surgery, or arterial disease. known peripheral, among other conditions, according to coauthor Geoffrey Barnes, MD, M.Sc., assistant professor of internal medicine and vascular cardiologist at Michigan Medicine Frankel Cardiovascular Center.
For others, “combination therapy may not be intentional; rather, adding aspirin might be overlooked because it’s not in a specialist’s or general caregiver’s territory, ”says Barnes.
The authors note that there are many medical conditions and situations in which the addition of aspirin with a direct oral anticoagulant has not been sufficiently studied. Schaefer adds that they plan to confirm the results of their study in a larger, longer study because there weren’t many blood clots that occurred during the period of this study, potentially limiting their ability to assess whether aspirin might be of benefit.
Previously, Schaefer and Barnes also reported a significant increase in side effects in people taking both aspirin and warfarin, another type of blood thinner.
Schaefer initially presented the results of these registry-based cohort studies at the 2019 American Society of Hematology annual meeting.
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Material provided by Michigan Medicine – University of Michigan. Original written by Haley Otman. Note: Content can be changed for style and length.