We thank Dr Bloom for his comments about the AFASAK 2 study we published.1 As commented on by Bloom, the cumulative risk for thromboembolic events in patients treated with aspirin, 300 mg/d, in the AFASAK 2 study was very close to that for patients receiving adjusted-dose warfarin sodium internationalized normal ratio of 2:3 (3.6% vs 2.8% after 1 year and 8.4% vs 8.3% after 3, respectively). However, the corresponding event rates in patients receiving aspirin, 300 mg/d, plus warfarin sodium, 1.25 mg/d, were 7.2% and 12.8%, respectively, and in patients receiving warfarin sodium, 1.25 mg/d, 5.8% and 11.9%, respectively. By comparing the cumulative event rates, no significant difference was found (P=.67) between the 4 study groups.
Gulløv AL, Koefoed BG, Petersen P, Pedersen TS, Andersen ED, Godtfredsen J, Boysen G. Warfarin vs Aspirin and AFASAK 2. Arch Intern Med. 1999;159(9):1010. doi: