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Review: oral anticoagulants plus aspirin reduce arterial thromboembolism more than oral anticoagulants alone but only in patients with mechanical heart valves

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 Q In adults requiring oral anticoagulant (OAC) therapy, what is the relative efficacy and safety of OACs plus aspirin compared with OACs alone?

METHODS

Embedded ImageData sources:

Medline (1966 to June 2005), EMBASE/Excerpta Medica (1980 to June 2005), Cochrane Central Register of Controlled Trials (Issue 2, 2005), reference lists, and experts.

Embedded ImageStudy selection and assessment:

randomised controlled trials (RCTs) that compared OACs plus aspirin with OACs alone (where OACs were administered to achieve the same target international normalised ratio [INR] or with the same fixed dose in both treatment arms) in adults requiring OAC therapy and that reported ⩾1 of 3 prespecified outcomes (see below) at ⩾3 months follow up. 10 trials (n = 4180) met the selection criteria. 4 trials were rated as high quality (>2 of 4 points), and …

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