Atrial fibrillation patients do not benefit from acetylsalicylic acid

Sara Sjalander, Anders Sjalander, Peter Svensson, Leif Friberg

Research output: Contribution to journalArticlepeer-review

54 Citations (SciVal)

Abstract

Oral anticoagulation is the recommended treatment for stroke prevention in patients with atrial fibrillation. Notwithstanding, many patients are treated with acetylsalicylic acid (ASA) as monotherapy. Our objective was to investigate if atrial fibrillation patients benefit from ASA as monotherapy for stroke prevention. Retrospective study of patients with a clinical diagnosis of atrial fibrillation between 1 July 2005 and 1 January 2009 in the National Swedish Patient register, matched with data from the National Prescribed Drugs register. Endpoints were ischaemic stroke, thrombo-embolic event, intracranial haemorrhage, and major bleeding. The study population consisted of 115 185 patients with atrial fibrillation, of whom 58 671 were treated with ASA as monotherapy and 56 514 were without any antithrombotic treatment at baseline. Mean follow-up was 1.5 years. Treatment with ASA was associated with higher risk of ischaemic stroke and thrombo-embolic events compared with no antithrombotic treatment. Acetylsalicylic acid as monotherapy in stroke prevention of atrial fibrillation has no discernable protective effect against stroke, and may even increase the risk of ischaemic stroke in elderly patients. Thus, our data support the new European guidelines recommendation that ASA as monotherapy should not be used as stroke prevention in atrial fibrillation.
Original languageEnglish
Pages (from-to)631-638
JournalEuropace
Volume16
Issue number5
DOIs
Publication statusPublished - 2014

Subject classification (UKÄ)

  • Cardiac and Cardiovascular Systems

Keywords

  • Atrial fibrillation
  • Stroke
  • Acetylsalicylic acid

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