Harvard Heart Letter

Heart beat: Study suggests limiting use of aspirin plus warfarin

Heart beat

Study suggests limiting use of aspirin plus warfarin

The combination of low-dose aspirin and warfarin (generic, Coumadin) is prescribed for a growing number of people with various forms of heart disease. For some, this dual therapy is just what they need. For others it may do more harm than good.

Both aspirin and warfarin prevent clots from forming in the bloodstream. They do this in different ways, so the combination should provide extra clot-preventing power. But each drug can also cause unwanted bleeding in the stomach and elsewhere.

The benefit clearly outweighs the risks in people with mechanical heart valves, according to a Canadian team's analysis in the Archives of Internal Medicine of 10 major trials of combined aspirin and warfarin. Not so for people who were taking the combination for atrial fibrillation or coronary artery disease, who experienced an increased risk of bleeding and little benefit.

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