New Study Challenges Use of Aspirin in Long-Term Treatment for Stent Patients
A recent study published in the scientific journal Circulation has raised concerns about the effectiveness and potential harm of prolonged aspirin use for high-risk cardiovascular patients with stents. The study examined over 7,500 patients with acute coronary syndrome, a term encompassing various heart conditions caused by a sudden drop in blood flow to the heart. These patients underwent percutaneous coronary intervention, a common procedure involving the insertion of a stent to open blocked arteries and promote blood flow.
Traditionally, a combination of aspirin and antiplatelet medication is prescribed for about a year after stent placement to prevent blood clots. However, the study found that eliminating aspirin from the regimen after three months was equally effective in preventing clotting complications, while significantly reducing the risk of severe bleeding associated with aspirin use. Dr. Roxana Mehran, the study’s principal investigator and a cardiologist at the Icahn School of Medicine at Mount Sinai, questioned the need for aspirin alongside a potent antiplatelet medication, stating that it only increases the risk of bleeding.
Cardiovascular diseases are a leading cause of death globally, causing nearly 18 million deaths annually. Aspirin has long been recommended as a preventative measure due to its ability to reduce blood clotting. However, it also carries a higher risk of severe bleeding, particularly in older individuals. Consequently, medical guidelines have shifted away from recommending daily aspirin for older adults without a high risk or existing heart disease. For young adults with an increased risk of heart attack or stroke, daily aspirin may have some benefit, but it should be weighed against bleeding risk.
Despite these changes, many healthcare professionals still believe in the benefits of aspirin for patients with heart problems or stents. The new study challenges this assumption by analyzing data from two large clinical trials involving patients with acute coronary syndrome and ongoing anti-clotting therapy. The results showed that patients who stopped taking aspirin after three months had similar outcomes to those on the aspirin-antiplatelet combination therapy, with equivalent rates of death, heart attacks, and strokes. Notably, dropping aspirin reduced the risk of severe bleeding by almost 50% without increasing cardiac complications.
This finding could lead to a new standard of care for high-risk cardiac patients. Dr. Mehran has incorporated the study’s results into her own treatment plans, prescribing aspirin for a shorter duration or even considering its removal after one month. Ongoing studies are investigating this shortened timeline. However, experts emphasize that aspirin remains an essential therapy for treating heart attacks, and the study’s findings do not apply to patients with other heart conditions requiring blood thinners.
Overall, the study highlights the potential for simplifying medication plans to improve patient outcomes. It challenges the notion that continuing medications is always necessary, advocating for further research on the value of medication withdrawal. By subtracting certain drugs, healthcare providers can improve treatment plans and patient health.
