What are the risks of concomitant antiplatelet therapy with oral anticoagulation in patients with atrial fibrillation (Afib) (AF)?

Updated: Apr 09, 2019
  • Author: Lawrence Rosenthal, MD, PhD, FACC, FHRS; Chief Editor: Jeffrey N Rottman, MD  more...
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Answer

Note that treatment risks exist with concomitant antiplatelet therapy with oral anticoagulation in patients with AF. A study analyzing concomitant use of aspirin and its association with clinical outcomes among AF patients treated with oral anticoagulation found a significantly increased risk for bleeding among those receiving both therapies. [63] Hospitalizations for bleeding events were also increased in the group treated with this treatment combination.

Of the 7347 AF patients on oral anticoagulation therapy who participated in the study, 2543 (35%) also received aspirin. [63] Among the patients treated with aspirin, 39% did not have a history of atherosclerotic disease and 17% had elevated ATRIA bleeding risk scores. Compared with patients receiving oral anticoagulation alone, those receiving concomitant aspirin had a significantly higher risk of major bleeding (adjusted hazard ratio [HR] 1.53, 95% confidence interval [CI] 1.20-1.96) and bleeding hospitalizations (adjusted HR 1.52, 95% CI 1.17-1.97). [63]


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