For people on warfarin, discontinuing aspirin use may significantly reduce bleeding events without compromising thrombotic risks.
Michigan-based researchers identified 6.7k adults receiving warfarin for AFib and/or venous thromboembolism and who were also taking aspirin unnecessarily. They then studied the effects of an aspirin deprescribing intervention—which was as simple as communicating to the primary care clinician that there isn’t a clear reason to give aspirin along with warfarin.
In the two-year pre-intervention period there was a slight decline in aspirin use (29.4% to 27.1%). Within the two years after the intervention:
- Aspirin use rates plummeted from 27.1% to 15.7%
- Bleeding rates declined from 0.31% to 0.21%
- Thrombotic risks did not change
Most people who are receiving long-term anticoagulation therapy like warfarin probably don’t need to be taking aspirin if they have not had a recent stroke, heart attack or cardiac procedure. This study provides randomized real-world results to support that recommendation and shows that a systematic approach to deprescribing aspirin could really help.