Key result
Concurrent DOAC and aspirin use without a clear indication was associated with increased bleeding compared with DOAC monotherapy (31.6 vs 26.0 bleeds per 100 patient-years, P=0.01).
Why the study?
It is unclear how many patients treated with a DOAC are using concomitant aspirin and how this affects clinical outcomes.
Does the addition of aspirin to DOAC therapy increase bleeding or reduce thrombosis in patients with AF or VTE without a clear indication for aspirin?
Population
3280 adults treated with a DOAC for AF or VTE without recent MI or valve replacement
Comparison
Concomitant DOAC plus ASA vs DOAC monotherapy
Design
Registry-based cohort study
Follow-up
Mean (SD) 20.9 (19.0) months
Authors
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DOAC plus ASA was associated with more bleeding; leaves open whether ASA deprescribing improves net outcomes in AF or VTE.
Cohort (n=3,280)
Yes
Does the addition of aspirin to DOAC therapy increase bleeding or reduce thrombosis in patients with AF or VTE without a clear indication for aspirin?
Absolute Event Rate: 31.6% vs 26%
p-value: p=.01
In patients with AF or VTE treated with a DOAC, the addition of aspirin without a clear indication is associated with increased bleeding and hospitalizations without reducing thrombotic events.
Schaefer et al. (2021) conducted a cohort in Atrial fibrillation (AF) or venous thromboembolic disease (VTE) (n=3,280). Concomitant acetylsalicylic acid (ASA) and DOAC therapy vs. DOAC monotherapy was evaluated on Any bleeding events (p=.01). Concurrent DOAC and aspirin use without a clear indication was associated with increased bleeding compared with DOAC monotherapy (31.6 vs 26.0 bleeds per 100 patient-years, P=0.01).
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