Aspirin ‘prescribed too often for stroke prevention’

Patients with atrial fibrillation are still regularly being prescribed aspirin for stroke prevention, despite the potential for dangerous side effects.

A European Society of Cardiology research paper has revealed that aspirin is commonly prescribed, either alone or in combination with an oral anticoagulant, for patients with myocardial infarction or coronary artery disease, despite concerns over its safety and efficacy.

Studies have revealed that giving aspirin to patients with atrial fibrillation could be harmful because it is minimally or not effective at stroke prevention, but is associated with a high risk of major bleeding or intracranial haemorrhage.

In particular, it was found that oral anticoagulants are underprescribed among elderly patients, with aspirin being more commonly used alone due to ongoing misconceptions about best practice.

Professor Gregory Lip, lead author of the European Society of Cardiology study, said: "There is a perception that elderly patients do not do well on anticoagulation. But a number of studies now … have shown that in elderly patients warfarin is far superior to aspirin in preventing stroke."

Patients in this category could benefit instead from anticoagulant therapy with older drugs like warfarin or newer, safer alternatives like Pradaxa and Xarelto.