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Patients with atrial fibrillation receiving oral anticoagulation often are treated with concomitant aspirin therapy, even when they do not have cardiovascular disease, according to data from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF).
The ORBIT-AF registry enrolled 10,126 patients with atrial fibrillation from 176 practices in the United States from June 2010 through August 2011. This analysis was limited to the 7,347 patients receiving oral anticoagulation. Hierarchical multivariable logistic regression models were used to assess factors associated with concomitant aspirin therapy. The primary study outcomes were 6-month bleeding, hospitalization, ischemic events, and mortality.
Of the 7,347 patients receiving oral anticoagulation, 2,543 (35%) also received concomitant aspirin therapy. More than one third of those patients had no history of atherosclerotic disease. Major bleeding (adjusted HR, 1.53; 95% CI, 1.20–1.96) and bleeding hospitalizations (adjusted HR, 1.52; 95% CI, 1.17–1.97) were significantly higher in patients receiving oral anticoagulation plus aspirin, compared with those treated with oral anticoagulants alone.