Low-intensity oral anticoagulation plus low-dose aspirin versus high-intensity oral anticoagulation alone: A randomized trial in patients with mechanical prosthetic heart valves

Abstract

The outcomes of the study were embolism, valve thrombosis, and major hemorrhage. The median follow-up was 23 months. The two treatments offered similar antithrombotic protection. The incidence of embolic episodes was 1.32 per 100 patient-years (95% confidence interval 0.53 to 2.7) for arm A and 1.48 per 100 patient-years (95% confidence interval 0.59 to 3.03) for arm B. Major hemorrhage occurred in 1.13 per 100 patient-years (95% confidence interval 0.41 to 2.45) for arm A and 2.33 per 100 patient-years (95% confidence interval 1.17 to 4.14) for arm B. Gastrointestinal bleeding was not increased by this combined reduced dose of aspirin and coumarin.

Increased Risk of Intracranial Hemorrhage when Aspirin Is Combined with Warfarin: A Meta-Analysis and Hypothesis

“…Conversely, the effect on ICH risk of adding aspirin is likely mitigated by reducing the INR [7, 8, 9, 16]. …”

“…Clinical trials in which the target intensity of anticoagulation was different between the aspirin/no aspirin arms were not included [7, 8, 9]. Six randomized clinical trials were identified and included in this analysis (none were excluded) [5, 10, 11, 12, 13, 14].…”

Gastroduodenal Mucosal Injury Profile in Long-Term Low-Dose Aspirin Users and Its Influencing Factors

“…10,[35][36][37][38][39] Only two studies showed results that combination with warfarin did not increase the risk. 40,41 In this study, there was also no significant difference of the occurrence of gastroduodenal mucosal injury between aspirin and warfarin co-medication group and aspirin only group. However, statistically significance of proportion difference between these two groups was difficult to analyse due to the small number of research subjects who used warfarin as co-medication.…”

Guidelines for Drug Therapy in Pediatric Patients With Cardiovascular Diseases (JCS 2012)

“…Prevention of myocardial ischemia is extremely important in patients who have coronary artery aneurysm (Tables 15 and 16). [23][24][25][26][27][28][29] III. Hyperlipidemia (Table 17) 26,30 Antihyperlipidemic drugs may be used for the treatment of familial hyperlipidemia in children, taking the growth of the vascular wall in childhood into due consideration (Table 17).…”