Does Long-Term Aspirin Effectively Lower Stroke Risk In Patients with AF?
Long-term aspirin therapy does not benefit patients with atrial fibrillation (AF) and low stroke risk following catheter ablation, and may increase their risk of bleeding, according to the results of a recent study.
For their study, researchers examined data from 4124 patients with AF who underwent ablation, comparing the long-term outcomes for all-cause mortality, cerebrovascular accident (CVA), transient ischemic attack (TIA) and major bleed between patients receiving antiplatelet, warfarin, or no therapy.
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CHADS2Vasc scores were 0 in 28%, 1 in 39%, and 2 in 34% of participants. Higher CHADS2Vasc scores were associated with female gender, hypertension, diabetes, heart failure, and vascular disease. Overall, 265 participants (6%) were taking warfarin, 707 (17%) were taking aspirin, and 3233 (78%) were taking no therapy at 3 years.
In patients taking warfarin, aspirin, and no therapy, incidence of all-cause CVA/TIA events was 1.4%, 3.0%, 3.9%, respectively. Incidence of gastrointestinal bleeding was 0.8%, 1.9%, 1.9%, respectively, and incidence of genitourinary bleeding was 1.7%, 2.8%, 2.1%, respectively. Incidences all increased with increasing CHADS2Vasc scores.
“After catheter ablation, low risk patients do not benefit from long-term aspirin therapy, and are at risk of higher rates of bleeding, compared to no therapy. If anticoagulation is preferred, these patients should remain on warfarin,” the researchers concluded.
—Michael Potts
Reference:
Bunch TJ, May HT, Bair TL, et al. Long-term aspirin therapy does not lower risk of stroke and increases bleeding risk in low risk atrial fibrillation ablation patients [presented at Heart Rhythm 2017]. May 13, 2017. Chicago, Illinois. Abstract C-PO06-37.