The risk of hemorrhage in long-term treatment with aspirin and triflusal

Introduction. Different studies have shown that aspirin (AAS), in low doses, may lend to a considerable frequency of hemorrhagic complications when used in the long term. Objective. We compare the long-term occurrence of hemorrhagic complications with low doses of AAS and high doses of triflusal. Patients and methods. Our series included 106 patients who took 900 mg triflusal per day (300 mg 3 times per day) and I I I who took AAS (330 mg/day once daily). The former were followed up for an average period of 48.3 months (20-94) and the latter for 46.3 months (2-84). The average follow-up period for the study was 47.3 months. The presence of hemorrhagic complications was evaluated as was their frequency and follow-up curve. Results. Compared with AAS, triflusal led to a 76% reduction in risk of hemorrhagic complications (2.8% against 10.8%; OR 0.24; IC 0.06-0.94). There was a slightly increased incidence of hemorrhages in the women's group. There were more hemorrhages than gastrointestinal hemorrhages (4.5% against 0.9%) and intracranial hemorrhages (1.8%-0.9%). The follow-up curve showed significant differences in the form of an increased risk of hemorrhagic complications with AAS. Conclusions. The risk of hemorrhage with AAS depended on the period of follow-up, in a similar manner to with oral anticoagulant agents, in patients with prophylaxis of cerebral infarct. On the other hand, this did not occur with triflusal, with which the risk was homogeneous and lower in the long term [REV NEUROL 1998; 27: 951-5].