Safety of combination aspirin and anticoagulation in acute ischemic stroke.
OBJECTIVE
To assess the risk of bleeding complications in patients treated with combination aspirin and heparin for cerebral ischemia.


METHODS
A retrospective, cohort study.


METHODS
A large urban teaching hospital.


METHODS
One hundred charts of stroke patients who had received anticoagulation with or without aspirin therapy were identified from the Stroke Data Bank. Bleeding rates were compared between the two groups.


RESULTS
Forty-two patients who had received heparin and/or warfarin in combination with aspirin were compared with 33 patients who had received anticoagulation alone. The mean duration of anticoagulant therapy was 8.0 and 8.4 days, respectively. Bleeding rates were not different between the two groups: 23.8 percent (10/42) (p = 0.78) and 24.2 percent (8/33), respectively. Although the bleeding rate was substantial, there was only one major bleed (severe epistaxis) occurring in a patient receiving anticoagulation only. No patient had an intracerebral hemorrhage.


CONCLUSIONS
Our data suggest that combination antithrombotic therapy is safe in a controlled, inpatient setting.
College of Pharmacy, Wayne State University, Detroit, MI 48202.
S C
SC
Fagan
H R
HR
Kertland
G E
GE
Tietjen
D000208:Acute Disease; D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use*; D001241:Aspirin / Q000009:adverse effects / Q000627:therapeutic use*; D002545:Brain Ischemia / Q000188:drug therapy*; D002561:Cerebrovascular Disorders / Q000188:drug therapy*; D015331:Cohort Studies; D004359:Drug Therapy, Combination; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors
D000925:Anticoagulants; D001241:Aspirin