New research shows that people with coronary artery disease who take a daily aspirin increase their risk of a heart attack within a week of stopping the medication. The study was conducted by researchers in France and was presented at a meeting of the American College of Chest Physicians in Orlando last week.The researchers looked at the records of more than 1,200 patients who were admitted to the hospital with chest pain. About 4 percent of the patients had withdrawn aspirin therapy 6 to 14 days before having a heart attack, unstable angina, or stent thrombosis. This is a condition in which a stent—a tiny metal device used to prop open a blocked artery—becomes clotted and inhibits blood flow through that artery.
All 51 of these patients had been taking aspirin every day for at least three months before terminating the medication. Many patients were advised by their doctors to stop taking aspirin because of a scheduled dental procedure or minor surgery. Others stopped taking aspirin because of bleeding, stomach irritation, or other problems.
It is common for doctors to direct patients to stop their aspirin a week before a planned surgery because aspirin is a known blood thinner and can prolong wound healing after surgery. But Dr. Richard Irwin, President of the American College of Chest Physicians says there are many procedures in which it is perfectly safe for patients to continue taking aspirin up until the day of their surgery.
“If you’re taking an aspirin because you’ve had a heart attack in the past—and we know that if you take an aspirin in that context that you’re less likely to die of another heart attack—then you shouldn’t stop,” said Dr. Irwin,
The drawback of this study is that did not have a control group. That is, it did not follow a similar population of people who continued taking aspirin during the same three years of the study to see if they too would end up suffering a coronary event.
“This study is new, it’s provocative and potentially very important, and suggests that another study should be done that would allow us to say really loudly and clearly what you need to do in this situation,” said Dr. Irwin.
And he says the study shows that doctors should not be withdrawing aspirin before a procedure in which there is little risk for bleeding complications.
The researchers agree the problem needs further study, and they write that although their research does not quantify the problem of aspirin withdrawal and heart attacks, it “nevertheless supports the hypothesis that aspirin withdrawal in coronary patients may represent a real risk for the occurrence of a new coronary event.”
Nearly 26 million Americans are taking an aspirin every day to prevent heart attacks or chest pain caused by unstable angina.
