It has long been thought that taking an aspirin a day could prevent strokes in patients with atrial fibrillation but a new study finds it may not be so. Researchers at the Intermountain Medical Center Heart Institute in Salt Lake City found that using long-term aspirin 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 were at risk of higher rates of bleeding compared to no therapy at all.
“When AF patients are considered low risk for stroke, physicians often treat them with aspirin rather than stronger anticoagulants to further lower that risk,” said Jared Bunch, MD, the study’s lead author and director of Heart Rhythm Research at the Intermountain Medical Center Heart Institute. “What was unknown was if aspirin was a safe and effective stroke prevention treatment after an ablation in lower-risk AF patients.”
“Traditionally, lower-risk AF patients have been treated with aspirin without significant supportive data,” he added.
Dr. Bunch and his team at the Intermountain Medical Center Heart Institute investigated the impact of long-term use of aspirin in 4,124 low-risk AF 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 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 AF patients. This study continues to show that aspirin has little to no benefit for stroke prevention in AF patients and when used in low-risk patients it significantly increases a patient’s bleeding risk.”
The study is being presented at Heart Rhythm 2017, the Heart Rhythm Society’s 38th Annual Scientific Sessions, in Chicago on Saturday, May 13.