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Aspirin fails to benefit certain patients with stable atherosclerosis
An observational analysis of outpatients with stable atherosclerosis indicated that aspirin fails to benefit those with no prior ischemic events, according to an investigation published in Clinical Cardiology.
Although these observational findings suggest that these patients show no benefit, Anthony A. Bavry, MD, associate professor of medicine at the University of Florida College of Medicine, cardiologist at the Malcom Randall Veterans Affairs Medical Center in Gainesville, Florida, and Cardiology Today’s Intervention Editorial Board member, said in a press release that patients who show signs of possible MI or stroke should still take aspirin as a treatment measure.
“Aspirin therapy is widely used and embraced by cardiologists and general practitioners around the world,” Bavry said. “The benefit of aspirin therapy is still maintained in acute events like [an MI] or a stroke.”
Bavry and colleagues analyzed patients from the REACH registry aged 45 years or older who had experienced MI or stroke (n = 21,724) and stable atherosclerosis but with no previous ischemic events (n = 11,872) in a propensity-score-matched study.
Each clinical visit was used to update aspirin use, and these results were used as a time-varying covariate.
The primary outcome was first occurrence of CV death, MI or stroke.
In patients with a prior ischemic event, there was a slightly reduced risk of first occurrence of CV death, MI or stroke at a median of 41 months (HR = 0.81; 95% CI, 0.65-1.01).
In patients without a prior ischemic event, there was no association between aspirin use and CV death, MI or stroke at a median of 36 months (HR = 1.03; 95% CI, 0.73-1.45).
According to the researchers, patients with coronary bypass or stent but no history of stroke, MI or arterial blood condition should stay on a regimen of aspirin, and it is important to discern aspirin’s effectiveness for various types of patients.
“The cardiology community needs to appreciate that aspirin deserves ongoing study. There are many individuals who may not be deriving a benefit from aspirin therapy,” Bavry said in the release.
Previously, the group showed that aspirin may not provide CV benefits for people with peripheral vascular disease. – by Dave Quaile
Disclosure: The REACH registry is sponsored by Bristol-Myers Squibb, Sanofi Aventis and the Waksman Foundation. Bavry reports receiving honoraria from the American College of Cardiology. Please see the full study of a list of the other researchers’ relevant financial disclosures.