Impact of Aspirin on Warfarin Control as Measured by Time in Therapeutic Range

Boyce, Michelle L; Zayac, Alexa; Davis, Arie; Badrick, Tony; Anoopkumar‐Dukie, Shailendra; Bernaitis, Nijole

doi:10.1111/bcpt.13037

Cited by 6 publications

(8 citation statements)

References 30 publications

(33 reference statements)

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“…This may be due to the fact that physicians tend to maintain a lower INR in patients on OAC plus antiplatelet when compared to patients taking OAC alone, which might be related to a fear of bleeding when they prescribed both drugs together [ 21 ]. This finding is similar to that from a previous report on the effect of aspirin on warfarin control in 4,494 patients taking warfarin [ 24 ]. They found a lower TTR when warfarin was combined with aspirin compared to warfarin alone.…”

Section: Discussionsupporting

confidence: 92%

The Rate of Clinical Outcomes in Atrial Fibrillation according to Antithrombotic Strategy: The COOL-AF Registry

Krittayaphong

Winijkul

Methavigul

et al. 2022

Cardiovascular Therapeutics

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Background. Ischemic stroke/transient ischemic attack (TIA), major bleeding, and death are common outcomes in atrial fibrillation (AF) patients, so appropriate antithrombotic therapy is crucial. The objective of this study was to investigate the rate of ischemic stroke/TIA, major bleeding, and death compared among AF patients who received oral anticoagulant (OAC) alone, antiplatelet alone, or OAC plus antiplatelet. Methods. Prospective data from the COOL-AF Registry (Thailand’s largest multicenter nationwide AF registry) were analyzed. Clinical, laboratory, and medication data were collected at baseline and during follow-up. Clinical outcomes, including ischemic stroke/TIA, major bleeding, and death, were collected. Results. There were 3,148 patients included. Mean age was 68.1 ± 10.8 years and 1,826 (57.7%) were male. AF was paroxysmal in 998 (31.7%), persistent in 603 (19.2%), and permanent in 1,547 (49.1%). The mean follow-up duration was 25.7 ± 10.6 months. The median rates of ischemic stroke/TIA, major bleeding, and death were 1.49 (1.21-1.81), 2.29 (1.94-2.68), and 3.89 (3.43-4.40) per 100 person-years. Antiplatelet alone, OAC plus antiplatelet, and OAC alone were used in 582 (18.5%), 308 (9.8%), and 2,258 (71.7%) patients, respectively. Antiplatelet alone significantly increased the risk of ischemic stroke/TIA and death compared to OAC alone. OAC plus antiplatelet significantly increased the risk of death compared to OAC alone. Conclusions. Antiplatelet was used in 890 (28.3%) AF, of whom 582 (18.5%) received antiplatelet alone, and 308 (9.8%) received antiplatelet and OAC. OAC plus antiplatelet significantly increased the risk of death without additional stroke prevention benefit. Antiplatelet alone should not be used in patients with AF.

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Section: Discussionsupporting

confidence: 92%

The Rate of Clinical Outcomes in Atrial Fibrillation according to Antithrombotic Strategy: The COOL-AF Registry

Krittayaphong

Winijkul

Methavigul

et al. 2022

Cardiovascular Therapeutics

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“…In our study, low‐dose aspirin use was significantly associated with a higher likelihood of linezolid‐induced thrombocytopenia. Low‐dose aspirin has antithrombotic properties, producing an inhibitory effect on platelet aggregation, and has been reported to cause drug‐induced immune thrombocytopenia . Our findings demonstrating the increased tendency of linezolid‐induced thrombocytopenia in relation to low‐dose aspirin therapy suggested a need for closer monitoring for thrombocytopenia occurrence during linezolid therapy.…”

Section: Discussionmentioning

confidence: 63%

Risk factors for linezolid‐induced thrombocytopenia in patients without haemato‐oncologic diseases

Choi

Lee

Chang

et al. 2018

Basic Clin Pharma Tox

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This study aimed to describe the occurrence and to evaluate the predictive factors of thrombocytopenia caused by parenteral linezolid in hospitalised patients without haemato-oncologic diseases. Using electronic medical records, a retrospective safety evaluation was performed among all hospitalised adult patients who received parenteral linezolid therapy between January 2005 and June 2016. Of all identified 264 patients with an average age of 63.4 (SD 15.8) years, thrombocytopenia occurred at a rate of 29.2% after an average of 11.2 (SD 7.4) days of the initiation of linezolid therapy. Significant predictive factors for thrombocytopenia included the duration of linezolid therapy longer than or equal to 7 days (adjusted odds ratios [ORs] 7.25, 19.51 and 28.80; 95% confidence intervals [CIs] 1.92-27.38, 4.76-79.95 and 6.48-127.92 for 7-13 days, 14-20 days and ≥21 days, respectively; P < 0.01 for all values), baseline platelet count <150 × 10 /mm (adjusted OR, 5.08; 95% CI, 2.06-12.55; P < 0.001), creatinine clearance <30 mL/min (adjusted OR, 4.19; 95% CI, 1.59-11.06; P = 0.004) and concurrent low-dose aspirin therapy (adjusted OR, 2.99; 95% CI, 1.26-7.08; P = 0.013). Baseline platelet count less than 150 × 10 /mm was an independent predictor of early-onset (≤6 days) thrombocytopenia (adjusted OR, 5.07; 95% CI, 1.46-17.58; P = 0.011). Closer monitoring of platelet count is required in patients who receive parenteral linezolid therapy for 7 days or more, and have low baseline platelet counts or impaired renal function.

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“…Of these, 588 articles were considered potentially eligible for full‐text review, and 72 ( n = 4 502 273) were included in the final analysis (see Figure 1). 22–93 …”

Section: Resultsmentioning

confidence: 99%

“…The characteristics and target outcomes of the included studies are listed in Table 1. We included 11 RCTs, 22–32 5 prospective cohort studies, 33–37 43 retrospective cohort studies, 51–93 and 13 case–control studies 38–50 . The studies included in the final analysis had been conducted in the United States (37.5%, 27/72), Canada (16.7%, 12/72), multiple countries (international studies) (6.9%, 5/72), Japan (6.9%, 5/72), Finland (5.5%, 4/72) and Australia (5.5%, 4/72).…”

Section: Resultsmentioning

confidence: 99%

“…The bleeding risk increased with both non-selective NSAIDs plus warfarin compared to warfarin alone (n = 80 483) (OR = 1.86; 95% CI 1.10-3.17), ‡ ‡ as well as for Cox-2 NSAIDs plus warfarin compared to warfarin alone (n = 57 575) (OR = 1.81; 95% CI 1.3-2.52). 39,56,58,59,67,85…”

Section: Anti-inflammatory Agents For Systemic Use (Nonsteroidal Anti-inflammatory Drug [Nsaids])mentioning

confidence: 99%

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Drug–drug interactions with warfarin: A systematic review and meta‐analysis

Wang

Zeraatkar

Obeda

et al. 2021

Brit J Clinical Pharma

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The objective of this paper is to systematically review the literature on drugdrug interactions with warfarin, with a focus on patient-important clinical outcomes.Methods: MEDLINE, EMBASE and the International Pharmaceutical Abstract (IPA) databases were searched from January 2004 to August 2019. We included studies describing drug-drug interactions between warfarin and other drugs. Screening and data extraction were conducted independently and in duplicate. We synthesized pooled odds ratios (OR) with 95% confidence intervals (CIs), comparing warfarin plus another medication to warfarin alone. We assessed the risk of bias at the study level and evaluated the overall certainty of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.Results: Of 42 013 citations identified, a total of 72 studies reporting on 3 735 775 patients were considered eligible, including 11 randomized clinical trials and 61 observational studies. Increased risk of clinically relevant bleeding when added to warfarin therapy was observed for antiplatelet (AP) regimens (OR = 1.74; 95% CI 1.56-1.94),

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Impact of Aspirin on Warfarin Control as Measured by Time in Therapeutic Range

Cited by 6 publications

References 30 publications

The Rate of Clinical Outcomes in Atrial Fibrillation according to Antithrombotic Strategy: The COOL-AF Registry

The Rate of Clinical Outcomes in Atrial Fibrillation according to Antithrombotic Strategy: The COOL-AF Registry

Risk factors for linezolid‐induced thrombocytopenia in patients without haemato‐oncologic diseases

Drug–drug interactions with warfarin: A systematic review and meta‐analysis

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