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Aspirin and clopidogrel are recommended for patients after acute myocardial infarction (AMI), and many AMI patients also have indications for a vitamin K antagonist. But combining these drugs can elevate risk for bleeding, which in turn can lead to morbidity and mortality.
To assess the safety of combinations of antiplatelet and anticoagulant drugs, Danish researchers used national registries to identify 40,000 adults who filled prescriptions within 90 days after first AMIs for one or more of three drugs: aspirin, clopidogrel, and a vitamin K antagonist.
During a mean follow-up of about 16 months, 1852 patients were hospitalized for nonfatal bleeding, and 115 fatal bleeding events occurred. With aspirin monotherapy as a reference, the adjuste…