Application Of Combining Asprin With Dipyridamole To Prevent Thromboembolic Events In Patients With Nonvalvular Atrial Fibrillation

Objective: To observe the efficiency(thrombo-embolic events risk) and safety(bleeding events) of combining aspirin with dipyridamole to prevent thrombo-embolism events in patients with nonvalvular atrial fibrilla-tion(NVAF) who are unsuitable for warfarin, and to provide a new anticoagu-lant choice for our nation(especially in outlying and poverty-stricken areas).Methods: 198 nonvalvular atrial fibrillation patients with CHADS2 score ≥ 1 were chosen from Jul. 2012 to May. 2014, and randomly divided into two groups. Group I was treated with aspirin combined with dipyridamole [(aspi-rin 100 mg once per day(q.d) plus dipyridamole 100 mg three times a day(tid) ], while group II received aspirin 100 mg q.d only. The incidence of thrombo-embolism(ischemic stroke and peripheral arteries embolism), hem-orrhage(intracranial hemorrhage, gastrointestinal tract, urinary tract, skin and mucosal bleeding, etc.) and other adverse events were observed and compared between two groups.Results:1 96 and 102 patients were assigned to group I and group II respectively. No significant difference(P>0.05) was observed in baseline information betw-een the two groups.2 There was no significant difference in CHADS2 score between two groups(P>0.05); mean score is 2.7.3 The average follow-up period was10~20(12±6) months. To the end, 2 cases was lost in group I, 3 in group II.4 2 cases suffered from ischemic stroke, 3 case suffered from peripheral artery embolism in group I. 9 cases suffered from ischemic stroke(1 death),1 case suffered from acute myocardial infarction, 4 cases suffered from periphe-ral artery embolism in group II. The incidence of ischemic stroke in group I was significantly lower than that in group II(2.1% vs 9.1% P=0.04), and the incidence of total thromboembolism in group I was significantly lower than that in group II too(5.3% vs 14.1% P=0.04).5 There was no serious hemorrhage in both groups. 7 and 4 cases suff-ered from minor bleeding in group I and group II respectively. There was no significant difference in bleeding rate between the two groups(7.4% vs 4.0% P=0.31).6 11 cases suffered from headache, 1 case suffered from Low platelet and 8 cases suffered from under xiphoid process pain in group I. 7 cases suf-fered from under xiphoid process pain in group II. The incidence of adverse events( headache is main) in group I was significantly higher than that in group II(21.3% vs 7.1% P=0.005).Conclusion: Aspirin/dipyridamole combination therapy is more effective than aspirin alone for the prevention of thromboembolism events in patients with NVAF and CHADS2 score ≥ 1.