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Aspirin in stroke prevention in atrial fibrillation (AF)

Authoring team

Role of Aspirin in stroke prevention in atrial fibrillation (AF)

  • evidence for effective stroke prevention with aspirin in AF is very weak
    • on the contrary, aspirin is associated with a significantly increased risk of bleeding and intracranial hemorrhage, especially in the elderly. As such, the use of aspirin should be reserved for only those patients who are intolerant to all forms of oral anticoagulant
    • addition of aspirin to other anticoagulant drugs is associated with a significantly increased risk of bleeding
    • patients with coexisting stable coronary artery disease who are on warfarin do not ordinarily require concomitant aspirin

NICE have stated (2):

  • do not offer aspirin monotherapy solely for stroke prevention to people with atrial fibrillation.

Reference:

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