Moderate
Established
설명
Low-dose aspirin combined with dabigatran increases bleeding risk; clinical evidence suggests a 2-fold increase in major bleeding events.
기전
Aspirin irreversibly inhibits platelet COX-1, reducing thromboxane A2 and impairing primary hemostasis; dabigatran inhibits secondary hemostasis by blocking thrombin.
임상적 중요성
The RE-LY trial showed substantially higher bleeding rates when aspirin was combined with dabigatran versus dabigatran alone.
관리 방법
Use combination only when there is a clear indication; monitor closely; add PPI; use lowest effective aspirin dose.