Aspirin and Warfarin Effective for Most Heart Failure Patients

A 10-year multi-center study found that aspirin and the blood thinner warfarin (brand name Coumadin®) were equally effective at preventing a combined risk of death, stroke, and cerebral hemorrhage in heart failure patients with normal heart rhythm.

Patients taking warfarin had slightly more than half the risk for stroke than those taking aspirin, but more than twice the risk for major bleeding. The researchers say that these results cancel each other out. After four years, warfarin appeared to be slightly more effective than aspirin, but the difference was of borderline significance.

The study, led by Shunichi Homma, MD, the Margaret Milliken Hatch Professor of Medicine, and John L.P. (Seamus) Thompson, PhD, of Columbia’s Mailman School of Public Health and College of Physicians & Surgeons, followed 2,305 patients at 168 study centers in 11 countries.

“Since the overall risks are the same for aspirin and warfarin,” said Homma, “the convenience and low cost of aspirin often make it the better choice. But both medications have side effects that must be considered for each patient.”

The study, “Warfarin and Aspirin in Heart Failure Patients in Sinus Rhythm,” was published online in the New England Journal of Medicine on May 2, 2012.