ISLAMABAD, August 23 (Online): People who have had a heart attack and do not take a daily aspirin have an elevated likelihood of recurring heart attack, stroke, or death compared to those who consistently take aspirin after the event.<\/p>\n
That\u2019s according to research presented today at the ESC Congress 2023. The findings have not been published yet in a peer-reviewed journal.
\nThe new study from Denmark examined the risk associated with discontinuing long-term aspirin compared to continued use after a heart attack.<\/p>\n
The researchers looked at data from the Danish nationwide health registry, which included 40,114 people, aged 40 and over, who had a first heart attack between 2004 and 2017.<\/p>\n
The participants were treated with a coronary stent and took aspirin during the first year after their heart attack. The researchers excluded people on anticoagulants and those who had a stroke or second heart attack within the first year.<\/p>\n
In Denmark, when people pick up an aspirin prescription, the number of tablets and the date they picked it up are recorded in registries, providing robust data for the study.<\/p>\n
The researchers evaluated aspirin use for the study participants at two, four, six, and eight years after the heart attack.<\/p>\n
Aspirin compliance declined at each checkpoint:
\n\u2022\tTwo years after the event, 90% continued to use aspirin
\n\u2022\tAt four years, 84% were in compliance
\n\u2022\tAt six years, 82% still used aspirin
\n\u2022\tAt eight years, compliance was at 81%
\nThe effectiveness of daily aspirin after a heart attack
\nIn the study, researchers reported that people who took aspirin as prescribed were less likely to experience another event than non-adherence for all four time points.
\n\u2022\tAt the two-year follow-up, those who had stopped taking aspirin had an 29% higher likelihood of a recurrent heart attack, stroke, or death.
\n\u2022\tAt the four-year follow-up, the participants no longer taking aspirin were 40% more likely to have a second event.
\n\u2022\tAt the six-year follow-up, the participants who no longer took daily aspirin had a 31% higher likelihood of a second event.
\n\u2022\tAt the eight-year follow-up, there was a 20% higher likelihood of a recurrent heart attack, stroke, or death for those no longer taking aspirin.<\/p>\n
\u201cThere has been a lot of discussion and a lot of back and forth on the pros and cons of taking aspirin for heart conditions,\u201d said Dr. Lawrence Phillips, the director of outpatient clinical cardiology at NYU Langone Heart and an associate professor in the Department of Medicine in the Leon H. Charney Division of Cardiology at NYU Grossman School of Medicine.<\/p>\n
\u201cIt is important to remember that this study does not address the general population. It is only talking about people who have had at least one prior cardiovascular event,\u201d Phillips, who was not involved in the study, told Medical News Today.<\/p>\n
Aspirin has been used for more than 100 years for minor pain and fever. While it is safe when used as directed, side effects include stomach upset and bleeding.<\/p>\n
\u201cAspirin is often portrayed as a safe treatment for heart conditions. However, this is true only for people who have had a previous cardiovascular event,\u201d said Dr. Michael Broukhim, an interventional cardiologist at Providence Saint John\u2019s Health Center in California who was not involved in the study.<\/p>\n
\u201cIt can be harmful when taken for no reason, including people who have not had a previous cardiovascular event. It should only be taken after a discussion with your doctor,\u201d he told Medical News Today.<\/p>\n
\u201cThe primary risk of low-dose aspirin is a small chance of bleeding. In patients who have had a previous heart attack or stroke, the risk of another event is high and the small chance of bleeding from a baby aspirin is far outweighed by a significantly lower risk of having another heart attack or stroke,\u201d said Dr. Sameer Amin, the chief medical officer at LA Care Health Plan in California who was not involved in the study.<\/p>\n
\u201cIn these cases, it is clear that people should take aspirin. For a person who has never had a heart attack or stroke and is otherwise healthy, the risk of a first event is lower. In those instances, the benefit may be low and it may not make sense to take on that low risk of bleeding,\u201d Amin told Medical News Today.<\/p>\n
Primary vs. secondary prevention
\nLast year, the U.S. Preventive Task Force concludedTrusted Source that daily aspirin use has little or no benefit for most people who are not at high risk of a cardiovascular event.<\/p>\n
Part of the confusion about when aspirin is beneficial is in understanding primary and secondary prevention.
\n\u201cWhen we think of prevention, we divide people into primary and secondary prevention,\u201d \u2018 said Dr. Yu-Ming Ni, a cardiologist and lipidologist at MemorialCare Heart and Vascular Institute at Orange Coast Medical Center in California who was not involved in the study.<\/p>\n
\u201cPrimary prevention is to prevent a first heart event; secondary prevention works to prevent a subsequent one,\u201d Ni explained to Medical News Today. \u201cAspirin therapy is a secondary prevention method. We should not prescribe aspirin if someone has not had a heart attack unless there are extenuating medical circumstances.\u201d<\/p>\n
\u201cI agree with the study\u2019s notion of how important aspirin is for people who have had a heart attack,\u201d Ni added. \u201cWe often assume that something is true based on our observation. This study gives us a clear answer. We now know that aspirin significantly reduces that risk for people at elevated risk of having subsequent heart events.\u201d<\/p>\n
Getting people to take a daily aspirin
\nConvincing people to take an aspirin every day isn\u2019t always an easy task.
\nAnother studyTrusted Source published today by researchers at Washington University School of Medicine in St. Louis and the University of Michigan reported that fewer than half of people worldwide who have had a heart attack or stroke take a daily aspirin.<\/p>\n
The researchers indicated that while they can\u2019t explain why aspirin is underused, they hypothesize that there are several reasons, including varying accessibility to healthcare, inconsistent messaging surrounding the use of aspirin, and the fact that aspirin is not always available over the counter as some countries require a prescription.<\/p>\n
The researchers looked at surveys completed by 124,505 people, with 10,589 self-reporting a history of cardiovascular disease.
\nThey reported that in low-income countries, only about 16% of those who had experienced a heart attack or stroke took aspirin to prevent a second or subsequent one.<\/p>\n
In lower middle-income countries, the rate rose to about 24%. Upper middle-income countries saw this number increase to 51%. In high-income countries, 65% of people with previous cardiovascular events took aspirin.<\/p>\n
How to know if you should take a daily aspirin
\nThere are a myriad of factors that could influence your doctor\u2019s recommendations on whether you should or shouldn\u2019t take aspirin, Broukim explained.<\/p>\n
For example, if you are taking Eliquis, your doctor could tell you to continue taking that and not take aspirin.
\n\u201cThe take-home message, as I see it, is that people should not make medical decisions independently,\u201d Phillips said. \u201cDo not change anything without first talking to your doctor. Patient care is individualized, so what is good for someone else may not be good for you.\u201d<\/p>\n
Sometimes, though, it can seem like some doctors recommend daily aspirin and others discourage it.
\n\u201cI do not think that is the way to look at the issue,\u201d said Dr. Dennis Finkielstein, the associate chair of cardiology at Northwell Lenox Hill Hospital in New York who was not involved in the study.<\/p>\n
\u201cAll doctors will consider what is best for the individual they are treating,\u201d he told Medical News Today. \u201cTherefore, some patients with elevated bleeding risks will be advised to discontinue aspirin if their cardiovascular disease is deemed stable and they are otherwise medically optimized. Other patients, with low bleeding risk, will be advised to continue aspirin therapy long-term.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"
ISLAMABAD, August 23 (Online): People who have had a heart attack and do not take a daily aspirin have an elevated likelihood of recurring heart attack, stroke, or death compared to those who consistently take aspirin after the event. That\u2019s according to research presented today […]<\/p>\n
\n","protected":false},"author":16,"featured_media":87857,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[9821],"tags":[],"class_list":["post-87856","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-latest-health-news"],"yoast_head":"\n