For patients with prosthetic heart valves at high risk of thromboembolism, combined warfarin and ASA therapy may be beneficial compared with warfarin alone. Combination therapy may also be used for primary prevention in patients at high risk for ischemic heart disease, although the expected benefits are small. Evidence does not support the use of combined antithrombotic therapy in patients with established ischemic heart disease, ischemic stroke, coronary artery bypass grafts or atrial fibrillation.
Combination therapy is associated with an increased risk of minor and major bleeding.
The highest dose of ASA that can be recommended in combination with warfarin is 100 mg daily. Une th rapie combin e est associ e un risque accru de saignement mineur ou majeur.