Why the study?
Does the addition of aspirin to oral anticoagulants increase the risk of intracranial hemorrhage?
Does the addition of aspirin to oral anticoagulants increase the risk of intracranial hemorrhage?
Adding aspirin to oral vitamin K antagonists more than doubles the risk of intracranial hemorrhage compared to oral anticoagulants alone.
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Supports avoiding aspirin with oral anticoagulants absent clear indication; reinforces bleeding risk evidence in combined antithrombotic therapy.
BACKGROUND: Oral anticoagulation with vitamin K antagonists increases the risk of intracranial hemorrhage; whether addition of aspirin to oral anticoagulation augments this risk is unclear. METHODS: Meta-analysis of randomized clinical trials in which aspirin was added to oral anticoagulants. RESULTS: Six randomized clinical trials were identified, including a total of 3,874 participants. Use of aspirin with oral anticoagulants was associated with more than double the frequency of intracranial hemorrhage (relative risk = 2.4, 95% CI = 1.2-4.8, p = 0.02). CONCLUSION: We hypothesize that aspirin when added to oral vitamin K antagonists may increase the risk of intracranial hemorrhage, but this observation requires confirmation. The magnitude of this effect is uncertain, and the clinical importance is likely different for different patient populations.
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Hart et al. (1999) studied this question.
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