Aspirin, Statins May Reduce Problems After Heart
TUESDAY, Oct. 19 (HealthDay News) -- Patients who took aspirin
before heart surgery suffered fewer heart attacks, stroke and other
problems after their operations, and those given statins had better
survival rates, two new studies find.
In the aspirin study, researchers identified 1,148 patients
undergoing bypass, valve or other scheduled cardiac surgeries. Of
those, 860 were taking aspirin in the five days before the surgery
and 288 were not taking aspirin.
During the 30 days after surgery, nearly 13 percent of patients
not taking aspirin experienced a heart attack, stroke or other
major cardiac event, compared to only 8.6 percent in the aspirin
group, the researchers found.
Aspirin also seemed to stave off post-surgery kidney failure,
said senior study author Dr. Jian-Zhong Sun, an associate professor
of anesthesiology at Thomas Jefferson University in
About 3.8 percent of those taking aspirin experienced kidney
failure after surgery, compared to 7 percent not taking
"At this time, we still don't have a proven therapy to prevent the major complications involving the heart, brain and kidney that are common after cardiac surgery," Sun said. "Aspirin looks like a simple and promising drug to prevent some major complications."
Many Americans with cardiovascular disease take low-dose aspirin
(81 milligrams/day). But the American Heart Association and the
American College of Cardiology recommends patients stop taking
aspirin before major surgery, including heart surgery, because
aspirin can increase the risk of excessive bleeding and the need
for blood transfusions, Sun pointed out.
More research needs to be done before he would recommend
changing those guidelines, Sun added.
"If confirmed in other studies, particularly if we can proceed to a randomized clinical trial that shows aspirin does not increase the bleeding, then at that time we can make a recommendation to change the practice guidelines," Sun said.
In the study, patients taking aspirin did not have a higher rate
of readmission due to infection, bleeding or fluid accumulation in
the chest and around the heart, Sun reported.
The patients taking aspirin also tended to be older, and more
likely to have hypertension, diabetes, peripheral artery disease
and a history of coronary artery disease. Even though the aspirin
group was on balance sicker than the non-aspirin group, they still
did better, Sun noted.
"This corroborates other research that shows, as simple as it seems, aspirin is effective," said Dr. Vincent Bufalino, president and CEO of Midwest Heart Specialists outside Chicago.
In a second study, researchers in Finland found that patients
who were not taking statins before undergoing coronary bypass
surgery were twice as likely to die as people who were taking the
Researchers identified 1,034 patients aged 42 to 81 undergoing
bypass surgery. Of those, 703 were prescribed statins before
surgery while 331 were not.
About 2.7 percent of patients given statins died in the month
following surgery, compared to about 5.1 percent of those not given
During the year after surgery, about 4 percent of those given
statins died, compared to nearly 11 percent of those not taking
statins, the researchers reported.
Statins are a widely prescribed class of drugs designed to lower
cholesterol. For heart patients, cholesterol-lowering isn't
necessarily the aim, Bufalino said. Research has shown statins can
also reduce inflammation that can lead to blood clots, which can
cause heart attacks and stroke.
It's common practice at U.S. hospitals for cardiac surgery
patients to be prescribed statins before leaving the hospital,
"There's been pretty convincing evidence that treating these people early and treating them regardless of their cholesterol level, whether it's high, medium or acceptable, is a good idea," Bufalino said. "This is just one more study providing solid evidence that putting these patients on statins clearly works."
The studies were to be presented Tuesday at the American Society
of Anesthesiologists annual meeting in San Diego.
American Heart Association has more on statins,
aspirin and other cardiac medications.
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