The goal of the study being presented in Amsterdam was to compare the heart attack, stroke, and death risks of people who stopped using aspirin therapy versus those who continued.
First-time heart attack patients aged 40 and older who were treated with a coronary stent and aspirin during the first year following their heart attack were included. Altogether, 40,114 patients were involved.
The patients were followed up at two-year intervals for eight years. At each of the follow-ups, compliance with the aspirin regimen was assessed by examining what proportion of days patients had access to the medication during the two years prior.
Anyone who used aspirin 80% of the time or less was deemed to be non-adherent. Those who took it more than 80% of the time, on the other hand, were considered to be adherent.
At each follow-up, people were excluded if they had had an additional heart attack, a stroke, or had died. They were also removed if they had begun treatment with anticoagulant medications or P2Y12 inhibitors, which are medications that work in a similar fashion as aspirin to prevent blood clots.
The researchers noted that compliance with the treatment went down over time. At two years, 90% were still using aspirin. However, by year eight, 81% of people were still taking the drug.
At each follow-up, the team found that people who were still using aspirin were less likely to experience heart attack, stroke, or death.
Specifically, those who were not using aspirin had a 29%, 40%, 31%, and 20% greater risk of having another heart attack, a stroke, or dying at each of the follow-ups respectively.
Even though taking aspirin after a heart attack is an effective way to prevent further heart attacks and strokes, the study in JAMA demonstrates not enough people who could benefit from the medication are taking it.
In this study, which included 124,505 participants from 51 nations around the globe, people were asked about their history of cardiovascular disease as well as aspirin use.
Among low-income countries, only 16.6% of people were taking aspirin as a preventive measure. In lower-middle-income countries, this figure rose to 24.5%; and, in upper-middle-income countries, 51.5% were using it.
“The answer depends on many factors,” he said, “such as their age, medical history, lifestyle, and medications,” with aspirin being an important part of that equation.
Foxman noted that, according to some studies, aspirin won’t help you if you’ve never had a heart attack or your risk is low to average.
However, if you’ve had previous cardiovascular events, studies show that taking aspirin regularly can reduce your risk of having further events.
“For example,” he noted, “research shows that among heart attack survivors, regular aspirin use can reduce the risk of a second heart attack, stroke, or cardiovascular-related death by about 25%. For stroke survivors, it lowers the risk of a second event by about 22%.”
Foxman, explained, however, that aspirin therapy is not right for everyone. It can cause side effects such as bleeding in the stomach or brain.
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