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Patients routinely treated with multiple blood thinners may have higher risk of bleeding events without a corresponding reduction in risk of blood clots.

Blood thinners are a type of medication used to prevent or deter the formation of blood clots. Anticoagulants are one type of blood thinner that work by thinning the blood to reduce the risk of clot formation. Brand name blood thinners include Lovenox and Coumadin. Antiplatelet drugs are also blood thinners. Aspirin and Plavix are two antiplatelet medications that slow clot formation caused when platelets clump together.

The prevention of blood clots is critical in patients at high risk of heart attack or stroke. Patients at high risk are those with existing heart disease, irregular heart rhythm, vascular disease, or history of deep vein thrombosis (DVT), among other conditions.

Like all medications, these drugs have side effects. Blood thinners can increase risk of bleeding incidents following surgery or an injury. Internal or gastrointestinal bleeding is a dangerous side effect that may or may not be quickly recognized depending on the symptoms of the patient.

A recent study from the University of Michigan published in the Journal of the American Medical Association (JAMA) suggests patients prescribed a daily aspirin (an antiplatelet drug) along with an anticoagulant may have an increased risk of bleeding events, without increased prevention of blood clots.

The research looked at patients who were prescribed direct oral anticoagulants (DOACs) and those taking DOACs along with an antiplatelet medication, like aspirin. The study took place between January 2015 and December 2019 and involved 3,280 patients. The patient group comprised approximately half men and half women, with a mean age of 68 years.

Researchers found one-third of the patients sampled who suffered atrial fibrillation (an irregular heart rhythm or AF) were treated with a DOAC plus aspirin. For these patients, aspirin would not likely be an indicated treatment as they had no history of heart attack or heart valve replacement. These patients were found to be at increased risk of a bleeding event leading to hospitalization, but had a similar rate of blood clots as those taking the DOAC medication alone.

Notes study lead, Dr. Jordan Schaefer with the University of Michigan, “The patients on combination therapy were more likely to have bleeding events but they weren’t less likely to have a blood clot…it’s important that patients ask their doctors if they should be taking aspirin when they are prescribed a direct oral anticoagulant.”

Gastrointestinal bleeding caused by blood thinners can be a serious injury leading to disability or death. If you take blood thinners on a regular basis, check with your physician to be sure you are taking the meds needed for your individual health profile.

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