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Coumadin or Aspirin Post LGI Bleed?

Coumadin or Aspirin Post LGI Bleed?

My dad, age 83 was hospitalized for a severe LGI bleed due to a mildly supra-therapeutic INR (~3.2) on a background of pancolonic diverticulosis.  Although the bleeding had spontaneously stopped, it was believed he had a sentinal bleed of a colonic origin.  His Hg dropped to about 58 and fortunately he did not suffer a second MI.  He was ressucitated, and had an admission GI workup, as well as echo (showing MR, severe TR, mild aortic valve sclerosis, no comment on LVEF).  His coumadin was held.  He has been back home for over 3 wks now and is well.

He has a h/o AFib and MI, is on digoxin, baby aspirin, lipitor, metoprolol, ramipril, mirapex (for RLS), flomax (for BPH), synthroid, omeprazole and until recently, coumadin.

His cardiologist is considering restarting the coumadin, while d/c'ing aspirin now that he's been off for a month based on the GI doctors report that if his Hg remains stable and he does not have a rebleed within the month, that it would be reasonable to restart it.

Two other cardiologists who are family friends have suggested he only go back on a baby aspirin a day and d/c coumadin.  Their reasoning is that the much lower risk of bleeding with aspirin, while accepting a slightly higher risk or a stroke is better than using coumadin with a much higher risk of bleeding and a slighly better risk of stroke prevention.  

I would very much like to have some guidance as to which way the evidence leans.

Thank you.
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