2023-08-23 04:31:17
People who have survived a heart attack should take low-dose acetylsalicylic acid (ASA; aspirin) over the long term. If they stop using the drug used to prevent blood clots, they are at increased risk of another heart attack, stroke, and death for many years. That’s according to a Danish study.
The results of a Danish study on the subject will be presented in the coming days at the annual congress of the European Society of Cardiology (ESC) in Amsterdam. The scientific event (25th to 28th August) is one of the largest medical congresses in the world. The Viennese heart specialist Franz Weidinger is the president of the European Society of Cardiology.
Many do not take the drug for long
The background of the scientific investigation with the evaluation of the data of 40,114 patients: ASA – in dosages of 50 or one hundred milligrams per day – has been one of the most important active ingredients in the so-called secondary prevention of heart attacks & Co. for 40 years. The acetylsalicylic acid with already far more than hundred years of history also acts as an inhibitor of blood platelet aggregation. The “platelet aggregation inhibitor” thus prevents the occurrence of blood clots, which is the cause of heart attacks or ischemic strokes. While the importance of ASA in the first prevention of such acute cardiovascular events is being pushed back more and more, its value in preventing further heart attacks or strokes is very well documented.
However, not all patients take the drug for many years. Anna Kristensen from Bispebjerg and Frederiksberg Hospital in Denmark and her co-authors analyzed data from 40,114 heart attack patients from 2004 to 2017. In Denmark, the use of medicinal products can be completely traced via register data. All subjects were older than 40 years, had received balloon dilatation via catheter and a stent to keep the affected coronary artery open following the heart incident. They took ASA for the first year following the event. Continuous secondary prevention was rated at 80 percent or higher with ongoing intake.
Study indicates good effect of ASA
Overall, the frequency of use steadily decreased over time: following two years it was 90 percent, following six years 82 percent and following eight years 81 percent. The main result, according to the European Society of Cardiology: “Compared to patients who used ASA, the patients without therapy adherence had a 29 percent higher risk of a heart attack, stroke or death following two years, following four years one to 40 percent higher risk, following six years a 31 percent higher risk and following eight years such acute incidents are 20 percent more frequent.”
The epidemiological study should therefore indicate a sustained good effect of ASA in heart attack patients. However, she might not clarify why those affected stopped taking the drug. This is where side effects might matter. It is also possible to switch to other blood clot-inhibiting medicines.
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