PMID: 9444297Jan 28, 1998Paper

Survey of cardiac surgeons' perceptions of the addition of ASA to warfarin for patients with mechanical heart valves

The Canadian Journal of Cardiology
J G Ray, A G Turpie

Abstract

Evidence suggests that the addition of acetylsalicylic acid (ASA) to warfarin therapy among patients with mechanical heart valves may reduce mortality, at a slightly higher bleeding risk. A survey was conducted of North American cardiac surgeons to assess whether they routinely use ASA in conjunction with anticoagulants among such patients. From a list of 142 cardiac surgeons and centres, questionnaires were successfully transmitted by fax to 137. Respondents were surveyed about their prescribing habits of both warfarin and ASA among patients with mechanical heart valves. Information collected included the target international normalized ratio (INR) and reasons for not routinely prescribing ASA, when applicable. One hundred and eighteen cardiac surgeons (86%) returned the questionnaire: 75% were American and 25% Canadian. All surgeons (100%) stated that they use warfarin for patients with mechanical valves, but there was little consensus about the target INR. Only 25 respondents (21%) routinely used ASA in conjunction with anticoagulants, while 90 (76%) said they would not. The most common reason cited for withholding ASA was the perceived increased risk of bleeding (49% of nonusers), while another 23% felt that there is no ben...Continue Reading

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