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Atrial fibrillation patients do not benefit from acetylsalicylic acid

Sjalander, Sara; Sjalander, Anders; Svensson, Peter LU and Friberg, Leif (2014) In Europace 16(5). p.631-638
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... (More)
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. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Atrial fibrillation, Stroke, Acetylsalicylic acid
in
Europace
volume
16
issue
5
pages
631 - 638
publisher
Oxford University Press
external identifiers
  • wos:000336080400006
  • scopus:84900330073
ISSN
1532-2092
DOI
10.1093/europace/eut333
language
English
LU publication?
yes
id
8b3d85a0-4847-420b-90c3-86c1e0a65f26 (old id 4559114)
date added to LUP
2014-08-01 07:42:27
date last changed
2017-11-12 03:00:07
@article{8b3d85a0-4847-420b-90c3-86c1e0a65f26,
  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.},
  author       = {Sjalander, Sara and Sjalander, Anders and Svensson, Peter and Friberg, Leif},
  issn         = {1532-2092},
  keyword      = {Atrial fibrillation,Stroke,Acetylsalicylic acid},
  language     = {eng},
  number       = {5},
  pages        = {631--638},
  publisher    = {Oxford University Press},
  series       = {Europace},
  title        = {Atrial fibrillation patients do not benefit from acetylsalicylic acid},
  url          = {http://dx.doi.org/10.1093/europace/eut333},
  volume       = {16},
  year         = {2014},
}