PREVALENCE OF ANEMIA AND OCCULT BLOOD LOSSES IN THE LONG-TERM FOLLOW-UP OF CARDIAC MECHANIC VALVE PATIENTS TREATED WITH A COMBINATION OF LOW-DOSE ASPIRIN PLUS LOW-INTENSITY ACENOCOUMARIN

Mechanic replacement of cardiac prostheses requires lifelong and high- intensity oral anticoagulant treatment. The addition of aspirin to cou marin treatment has resulted in more effective thromboembolic preventi on, though it also led to increased (digestive) bleeding. Aspirin enha nced the risk of apparent or occult gastrointestinal bleeding in a dos e-dependent fashion. The combined use of low-dose aspirin/low-intensit y coumarins might offer a safer approach. We prospectively evaluated t he prevalence of anemia markers in 127 prosthesic valve patients, rece iving two treatment modalities: Group A comprised 62 patients who rece ived 100 mg acetylsalicylic acid (ASA) added to acenocoumarin [interna tional normatized ratio (INR) 2.5-3.5]. Group B comprised 65 patients receiving acenocoumarin alone (INR, 3.5-4.5). We found no significant differences in the mean values for the blood markers of anemia or for the presence of blood losses in urine and feces. The addition of low-d ose ASA to less intense chronic anticoagulation does not increase the risk of developing anemia.