Aspirin Risks: Blood Thinners & Potential Harm
Here’s a breakdown of the key information from the provided text, organized for clarity:
Main Point:
The AQUATIC trial suggests that for patients with stable chronic coronary artery disease (CAD) who also require anticoagulation (e.g., due to atrial fibrillation), anticoagulation alone is sufficient and adding an antiplatelet (like aspirin) is not necessary and increases bleeding risk.Key Details:
Current Practice (US vs. Europe): In the US, its common to prescribe both an anticoagulant and aspirin to these patients, even though evidence supporting this practice is weak. This is less common in Europe.
AQUATIC Trial Findings: The trial demonstrates that anticoagulation alone is effective in this patient population.
Stable CAD is Key: This applies to patients with stable chronic CAD. The trial excluded patients who had a coronary stent placed within the last 6 months. those patients would likely still need a combination of therapies.
Why the Practice Persists: some doctors believe an antiplatelet is needed to prevent ischemic events (heart attacks) in patients with CAD, even while on an anticoagulant.
Hope for Change: the author (dr. Bhatt) hopes these results will change clinical practice. Similar trials from East Asia support the same conclusion.
About the Author:
Deepak L. Bhatt, MD, MPH: Director of Mount Sinai Fuster Heart Hospital, Dr. Valentin Fuster Professor of cardiovascular Medicine at Icahn School of Medicine at mount Sinai, and a Healio | Cardiology Today Editorial Board Member.
Disclosures: Dr. Bhatt has financial ties to many pharmaceutical and device companies, but not to Bayer (the company that partially funded the study).
study Information:
Study Name: AQUATIC
Presenters: Gilard M, et al. Conference: European Society of Cardiology Congress,August 29-September 1,2025,Madrid.
Funding: Partially funded by Bayer Healthcare.
Disclosures: Gilard reports no relevant financial disclosures.