A new study has confirmed the importance of continuing to take aspirin daily long term for patients with a history of heart disease, finding that patients who stop taking aspirin are at a significantly increased risk of life threatening heart conditions than those who continue with the over the counter pain reliever.

Aspirin interferes with the blood’s clotting action. When a person bleeds, the blood’s clotting cells, called platelets, build up at the site of the wound. The platelets help form a plug that seals the opening in the blood vessel to stop bleeding.

However, clotting can also happen within the vessels that supply your heart and brain with blood. If the blood vessels are already narrowed from atherosclerosis, the buildup of fatty deposits in arteries, a fatty deposit in the vessel can burst. Then, a blood clot can quickly form and block the artery. This prevents blood flow to the heart or brain and causes a heart attack or stroke. Aspirin therapy reduces the clumping action of platelets and thus possibly preventing heart attack and stroke.

Researchers analyzed data of 39,513 patients from the Health Improvement Network, a large UK database of primary care records. Patients were aged 50 to 84 years, with a first low-dose aspirin prescription for the prevention of cardiovascular outcomes from 2000 to 2007, and were followed for three years.

The analysis compared 1,222 cases and 5,000 controls. Aspirin had been discontinued in 12.2% of cases and 11% of controls. Discontinuation was associated with a clinically and statistically significant increase in risk of nonfatal myocardial infarction (MI) and in the combined outcome of death from CHD and nonfatal MI. There was no significant difference in risk of CHD death alone.

The doctors who conducted the research state:

“Doctors should maintain their patients on low-dose aspirin as long as they can and carefully assess individual patients for the risk of both thrombosis and bleeding before discontinuing aspirin for invasive procedures. Patients who need to discontinue aspirin should do so for the minimum time necessary. Reducing the number of patients who discontinue low-dose aspirin could have a major impact on the benefit obtained with low-dose aspirin in the general population.”

Although strong evidence supports the protective effects of low-dose aspirin, around 50% of patients discontinue treatment, which means approximately four additional MIs each year for every 1,000 patients who discontinue aspirin. The increased risk was present irrespective of the length of time the patient had previously been taking low-dose aspirin.

Dr Giuseppe Biondi-Zoccai from the University of Modena, Italy and Dr Giovanni Landoni of Università Vita-Salute San Raffaele, Milan, Italy write:

“Any day off aspirin is a day at risk for patients with previous cardiovascular disease. Patients on chronic low-dose aspirin for secondary prevention of cardiovascular disease should be advised that unless severe bleeding ensues or an informed colleague explicitly says so, aspirin should never be discontinued given its overwhelming benefits on atherothrombosis, as well as colorectal cancer and venous thromboembolism.”

Source: The British Medical Journal

Written by Sy Kraft