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Long-term Aspirin use doesn't lower risk of stroke for some patients with atrial fibrillation


A new study by researchers at the Intermountain Medical Center Heart Institute in Salt Lake City found that using long-term Aspirin ( Acetylsalicylic acid ) therapy to prevent strokes among patients who are considered to be at low risk for stroke may not be effective as previously thought.

The study found that atrial fibrillation patients who received a catheter ablation and were low risk of stroke didn't benefit from long-term aspirin therapy, but are at risk of higher rates of bleeding compared to no therapy at all.

Stroke risk is a significant concern in patients with atrial fibrillation, and patients who undergo a catheter ablation for atrial fibrillation have lower long-term stroke rates compared to atrial fibrillation patients who aren't treated with an ablation.

Traditionally, lower-risk atrial fibrillation patients are treated with Aspirin without significant supportive data.

Researchers at the Intermountain Medical Center Heart Institute investigated the impact of long-term use of Aspirin in 4,124 low-risk atrial fibrillation patients who underwent catheter ablation.

The study showed that over a three-year period, those who were on Aspirin had a significantly higher risk for gastrointestinal bleeding and genitourinary bleeding compared to those on Warfarin ( Coumadin ) or who weren't treated at all.

In both the general and medical communities, Aspirin therapy is perceived to reduce risks, it's easy to prescribe, and it's available worldwide over-the-counter.
There's always been little evidence to support its use for stroke prevention in atrial fibrillation patients.

In conclusion, data have highlighted that Aspirin conveys no significant benefit for stroke reduction in low stroke-risk atrial fibrillation patients and it actually elevates the risk of bleeding.
When stroke risk may be further lowered by the process of catheter ablation for atrial fibrillation, the long-term lack of benefit and elevated bleeding risks associated with Aspirin use become even more apparent. ( Xagena )

Source: Heart Rhythm Society's 38th Annual Scientific Sessions, 2017

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