Can AFib patients take aspirin to reduce the risk of stroke?

Atrial fibrillation or AFib is a specific type of arrhythmia that occurs in the top chambers of the heart. Symptoms may include heart palpitations, shortness of breath, fatigue, light headedness, dizziness, and sometimes passing out. AFib on its own is not generally life threatening, but patients with AFib do have a higher risk of stroke than the average population.

When assessing a patient’s risk of stroke, physicians at the Oklahoma Heart Hospital use the CHADS VASC scoring system. This system assigns risk factors based on age, gender, other health conditions such as diabetes, and existing heart conditions, including congestive heart failure, prior stroke, hypertension, or other vascular disease. Most patients diagnosed with AFib will score a 1 or higher on the CHADS VASC scoring system, at which point blood thinners are prescribed to reduce the stroke risk.

Patients frequently ask if aspirin is an effective blood thinner for reducing the stroke risk associated with atrial fibrillation. Currently in the American Academy of Cardiology guidelines, aspirin is listed as an option for patients with a CHADS VASC score of 1. In contrast, the European guidelines have completely eliminated aspirin as a treatment option to reduce stroke risk associated with AFib. Why? In multiple randomized trials, only one trial showed aspirin to be more effective than placebo, and only slightly so in that trial.

Some patients may perceive aspirin to be a safer option for a blood thinner, as it’s an over-the-counter medication. It’s also cheaper compared to most prescription blood thinners. However, the bleeding risk from aspirin is comparable to other prescription blood thinners. The similar bleeding risk combined with the questionable effectiveness for reducing stroke risk means aspirin is not a good option for most AFib patients.

While aspirin may not be an effective approach to reducing stroke risk in AFib patients, it may still be prescribed as a treatment for other heart conditions. If you are currently taking aspirin prescribed by a physician, do not stop taking your medication without speaking with your doctor. If you have questions about medications to treat AFib or other heart conditions, contact the Oklahoma Heart Hospital today to schedule an appointment with one of our physicians.