A-Fib Drug Therapy:Atrial Fibrillation: Resources for Patients

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Dr. Wilber Su,
Cavanaugh Heart Center, Phoenix, AZ

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Ira David Levin, heart patient,
Rome, Italy

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Walter Kerwin, MD, Cedars-Sinai Medical Center, Los Angeles, CA

FAQs A-Fib Drug Therapy: Warfarin + Aspirin?

8. “I’m on warfarin. Can I also take aspirin, since it works differently than warfarin? Wouldn’t that give me more protection from an A-Fib (ischemic) stroke?”

No, combining is dangerous.

Preliminary research indicates that combining anticoagulants (warfarin) and antiplatelets (aspirin) in the same patient is associated with a substantially higher risk of fatal or non-fatal internal bleeding.

There’s no indication that combining warfarin with an antiplatelet (aspirin, clopidogrel, or both) reduces the risk of ischemic stroke.

Added 8/10/15. Aspirin is no longer recommended as first-line therapy:

Aspirin has been downgraded from class 1 in the 2006 guidelines to class 2B in the 2014 guidelines.

In a Danish registry study, aspirin didn’t show any benefit for stroke prevention.¹ And in the European ESC guidelines, aspirin is not recommended as first-line therapy for patients with a CHA2DS2-VASc score of 1.²

Return to FAQ Drug Therapies

Footnote Citations (↵ returns to text)

Olesen, JB et al. Risks of thromboembolism and bleeding with thromboporphylaxis in patients with atrial fibrillation: a net clinical benefit analysis using a ‘real world’ nationwide cohort study. Thromb Haemost 2011;106:739-749↵
Camm, AJ et al. 2012 focused update of the ESC Guidelines for the management of atrial fibrillation: an update of the 2010 ESC Guidelines for the management of atrial fibrillation. Developed with the special contribution of the European Heart Rhythm Association. EUR Heart J 2012;33:2719-47↵

Added 8/10/15. Aspirin is no longer recommended as first-line therapy:

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