Bleeding Complications in Treatment with Asa and Anticoagulants

Abstract

Patients with prosthetic heart valves have a reduced platelet adhesiveness and a high incidence of arterial thromboembolic episodes. Therefore 148 patients with aortic ball valve prostheses were chosen for an antithrombotic study. They received either one gm. of ASA or placebo in combination with anticoagulants. In two years, 15 bleeding episodes developed in those taking ASA, seven during the first month. Two had intracranial hemorrhage, one died, while the others recovered completely. Six episodes occurred in the placebo group, three intracranial complications caused two deaths. The higher incidence of bleeding in the combined group was entirely due to gastrointestinal hemorrhage. In both groups, the occurrence and severity of bleeding correlated to the intensity of anticoagulant therapy. Low platelet adhesiveness also predisposed to bleeding.