There was an analysis of the safety and efficacy of adding aspirin to warfarin
published as a
substudy of the SPORTIF trials, first author was Scott Kasner.
It showed that adding aspirin to either coumadin (or ximelagatran) in high risk
patients with hx of
stroke and atrial fibrillation (eg those with coexisting coronary disease) did
not lower the
ischemic event risk, but significantly raised the risk of major bleeding. Based
on that, I would be
very wary of adding aspirin at any dose to warfarin.
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