Low-Dose Daily Aspirin Enough to Help Heart Attack
SATURDAY, March 24 (HealthDay News) -- Heart attack patients who
take either a high or low dose of aspirin daily have the same level
of protection against another heart attack or other cardiovascular
events such as stroke, according to a new study.
Along with anti-clotting drugs, a daily aspirin is recommended
for nearly all of the more than one million Americans who suffer a
heart attack each year, but the most effective dose hasn't been
Higher doses of aspirin typically come with higher bleeding
risks, so determining whether a high dose is needed or not has
patient safety implications.
To clarify the issue, researchers analyzed data from more than
11,000 heart attack patients around the world who were prescribed
either a low daily dose (150 milligrams or less) or a high daily
dose (more than 150 milligrams) of aspirin along with anti-clotting
The findings were to be presented Saturday at the annual meeting
of the American College of Cardiology in Chicago.
"We observed no difference between patients taking a high dose versus a low dose of aspirin as it relates to cardiovascular death, heart attack, stroke or stent thrombosis [clot]," lead author Dr. Payal Kohli, a cardiology fellow at Brigham and Women's Hospital, said in a hospital news release.
"Interestingly, we did find a dramatic difference in practice patterns of physicians in North America compared to those in the rest of the world," Kohli added. "North American physicians prescribed a high dose of aspirin for two-thirds of all their patients, while the exact reverse was true of the rest of the world. International physicians prescribed a low dose of aspirin to more than two-thirds of their patients."
Patients who received high doses of aspirin were more likely to
have cardiac risk factors and higher cholesterol levels, while
those who received low doses were more likely to be white and have
no prior history of high blood pressure.
One expert said the study confirms there is "no role for
high-dose aspirin" in this type of scenario. Dr. Jenifer Yu, a
cardiologist and research fellow at Mount Sinai Medical Center in
New York City, said she and her colleagues published similar
findings at the American Heart Association annual meeting in
In that study, "after adjusting for baseline differences in the
two groups, we found that the use of high-dose aspirin (greater
than 200 milligrams) afforded no additional protection with respect
to ischemic events [such as heart attack or stroke] in comparison
to low-dose aspirin (less than 200 milligrams)," Yu noted.
"However, patients on high-dose aspirin experienced more major
bleeding," she added.
The newer study from Brigham & Women's also found that the
anti-clotting drug prasugrel (brand name Effient) was more
effective at preventing major cardiovascular events than the
anti-clotting drug clopidogrel (brand name Plavix), regardless of
whether patients took low- or high-dose aspirin.
Findings presented at medical meetings are typically considered
preliminary until published in a peer-reviewed journal.
The American Heart Association has more about
aspirin and heart disease.
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