Two blood thinners at once: More risk with the same reward

Two blood thinners at once: More risk with the same reward

 

More blood thinners aren’t automatically better, another study confirms.

A new publication in JAMA Internal Medicine focuses on the minimal pros and the concerning cons of combining a daily aspirin with a drug from the newer class of anticoagulants that include apixaban, dabigatran, edoxaban and rivaroxaban.

Patients were taking one of these direct oral anticoagulants known as DOACs to prevent strokes from non-valvular atrial fibrillation or for the treatment of venous thromboembolic disease (deep vein thrombosis or pulmonary embolism). The included patients did not have another reason to take aspirin such as a recent history of a heart attack or a history of a heart valve replacement. The researchers discovered that almost one-third of the people who were prescribed a DOAC were also taking aspirin without a clear reason for the aspirin.

“The patients on combination therapy were more likely to have bleeding events but they weren’t less likely to have a blood clot,” says lead author Jordan Schaefer, M.D., an assistant professor of internal medicine and a hematologist at Michigan Medicine, the academic medical center of the University of Michigan. “Therefore, it’s important that patients ask their doctors if they should be taking aspirin when they are prescribed a direct oral anticoagulant.”

The combination of an anticoagulant and an antiplatelet may be appropriate for people who have had a recent heart attack, recent coronary stent placement or bypass surgery, prior mechanical valve surgery or known peripheral artery disease, among other conditions says co-author Geoffrey Barnes, M.D., M.Sc., an assistant professor of internal medicine and a vascular cardiologist at the Michigan Medicine Frankel Cardiovascular Center.

For the others, “combination therapy may not be happening intentionally; rather, the addition of aspirin might get overlooked because it’s not in any one specialist or general care provider’s territory,” Barnes says.

The authors note that there are many medical conditions and situations where adding aspirin with a direct oral anticoagulant has not been adequately studied. Schaefer adds that they plan to confirm their study findings in a larger, longer study because there were not many blood clots that occurred during the timeframe of this study, potentially limiting their ability to assess if aspirin could be beneficial.

Previously, Schaefer and Barnes also reported a significant increase in adverse outcomes for people taking both aspirin and warfarin, a different kind of anticoagulant.

Schaefer originally presented these registry-based cohort study results at the 2019 annual meeting of the American Society of Hematology.

 

Original study

Plant-based diet can slash severity of COVID-19, finds major new study

Plant-based diet can slash severity of COVID-19, finds major new study

Following a plant-based diet could help decrease the severity
of COVID-19, according to a new major study published in the

The rejuvenating impact of nature on our health and well-being

Detoxing Our Environments

Strange and Bizarre: Pink drinks can help you run faster and further, study finds

Strange and Bizarre: Pink drinks can help you run faster and further, study finds

A new study led by the Centre for Nutraceuticals at the
University of Westminster shows that pink drinks can help to

Chemicals in the Kitchen

Compound isolated from sea sponge fights cancer cells

News

A new study led by investigators at Brigham and Women's Hospital takes a new approach to mapping spirituality and religiosity and finds that spiritual acceptance can be localized to a specific brain circuit. This brain circuit is centered in the periaqueductal gray (PAG), a brainstem region that has been implicated in numerous functions, including fear conditioning, pain modulation, altruistic behaviors and unconditional love.

Working out just five minutes daily via a practice described as "strength training for your breathing muscles" lowers blood pressure and improves some measures of vascular health as well as, or even more than, aerobic exercise or medication, new CU Boulder research shows.

Anxiety about re-entering society as the world continues to grapple with the pandemic is real. How, then, do we move forward from the collective trauma of COVID-19?

The wonderful organisation Open Source Wellness in the USA has an extremely useful and practical approach to mental emotional health. Predicate upon the idea that creting structure in your day can make dramatic improvement to mental health.

The COMPLEMENTARY MEDICAL ASSOCIATION (The CMA) © 2012. No part of this site may be reproduced without the express permission of The Complementary Medical Association. If used without prior consent a charge of US $1,000 per article, or mini section is paid (US $50 per word (minimum) will be charged. This is not meant to reflect a commercial rate for the content, but as a punitive cost and to reimburse The CMA for legal fees and time costs). Use of the contents, without permission will be taken as consent to bill the illegal user in full.