Evaluation of the Use of Primary Prevention Aspirin in Patients With Atrial Fibrillation Receiving a Direct Oral Anticoagulant for Stroke Prevention

In patients with AF and no history of ASCVD, the addition of low-dose aspirin to DOAC therapy significantly increased risk of major bleeding and CRNMB without reducing ischemic events. These findings support deprescribing aspirin for primary prevention in this population to minimize bleeding risk while maintaining thromboembolic prevention.

Authors

Thomas W. Szymanski (ORCID: https://orcid.org/0000-0002-8692-9675)
Jordan L. Lacoste (ORCID: https://orcid.org/0000-0002-0804-584X)
Seher Berzingi (ORCID: https://orcid.org/0009-0004-8885-3741)
Matthew Rockhold (ORCID: https://orcid.org/0009-0006-7149-4695)
Lauren Kunkel
Storee Yzaguirre
Megan Vaughan

Institutions

West Virginia University (US)
Hospital of the University of Pennsylvania (US)
University of North Texas System (US)
West Virginia University Hospitals (US)

Publication Details

Journal: Annals of Pharmacotherapy
Published: 2025-12-26
DOI: https://doi.org/10.1177/10600280251401892
Primary Topic: Atrial Fibrillation Management and Outcomes
Type: article
Field-Weighted Citation Impact: 0.00

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article

Evaluation of the Use of Primary Prevention Aspirin in Patients With Atrial Fibrillation Receiving a Direct Oral Anticoagulant for Stroke Prevention

Thomas W. Szymanski, Jordan L. Lacoste, Seher Berzingi, Matthew Rockhold et al.

Dec 26, 2025

Annals of Pharmacotherapy

Atrial Fibrillation Management and Outcomes

article

Evaluation of the Use of Primary Prevention Aspirin in Patients With Atrial Fibrillation Receiving a Direct Oral Anticoagulant for Stroke Prevention

Thomas W. Szymanski, Jordan L. Lacoste, Seher Berzingi, Matthew Rockhold, Lauren Kunkel, Storee Yzaguirre, Megan Vaughan

December 26, 2025article en

Abstract

In patients with AF and no history of ASCVD, the addition of low-dose aspirin to DOAC therapy significantly increased risk of major bleeding and CRNMB without reducing ischemic events. These findings support deprescribing aspirin for primary prevention in this population to minimize bleeding risk while maintaining thromboembolic prevention.

Annals of Pharmacotherapy

West Virginia University (US), Hospital of the University of Pennsylvania (US), University of North Texas System (US), West Virginia University Hospitals (US)

Good health and well-being

Openalex Percentile: Top 31%

Atrial Fibrillation Management and Outcomes

DOI Source OpenAlex

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Evaluation of the Use of Primary Prevention Aspirin in Patients With Atrial Fibrillation Receiving a Direct Oral Anticoagulant for Stroke Prevention — Thomas W. Szymanski, Jordan L. Lacoste, et al. · Annals of Pharmacotherapy (2025) | TGRS Research Map | TGRS