According to a study, discontinuing aspirin for some people who had been taking it to prevent heart disease may make them more susceptible to cardiovascular events.
This suggests an individualized strategy for aspirin use, challenging the guidelines as they stand. The applicability of the current aspirin recommendations to all patients is called into question by an analysis of data from multinational trials.
Heart disease researchers have discovered a subset of patients for whom global guidelines on aspirin use may not be appropriate.
The results of an analysis of data from three clinical studies, which was published in the prestigious medical journal Circulation, cast doubt on the current recommendations for the use of the medication in the primary prevention of atherosclerotic cardiovascular disease, which is another name for heart disease and stroke.
The study looked at 2018 publication data from clinical trials with over 47,000 participants across ten nations, including the US, UK, and Australia.
Subgroup analysis provides fresh perspectives. The results for a subgroup of 7,222 individuals who were already taking aspirin prior to the start of the three trials were the main focus of the research. The participants in the study had a higher risk of cardiovascular disease and were taking aspirin to avoid having a heart attack or stroke for the first time.
The findings revealed that individuals who used aspirin prior to the trials and quit taking it had a higher risk of heart disease or stroke (12.5% versus 10.4%) than those who continued taking the medication.
Additionally, analyses revealed no statistically significant variation in the risk of serious bleeding. Crucially, aspirin is still advised for high-risk individuals who have already experienced a heart attack or stroke in order to lower the chance of another incident.
The Increased risk of major bleeding observed with this common medication in the three trials is the driving force behind the recent guidelines moving away from primary prevention aspirin. However, major bleeding is relatively uncommon on aspirin and was most noticeable only among trial participants who were started on aspirin during the trial, rather than those who were taking aspirin safely beforehand.
Maintaining Aspirin:
A Reasonable Strategy The main goal of these trials was to determine how beginning aspirin treatment could lower the risk of atherosclerotic cardiovascular disease in people who had never taken the medication before. People who are currently receiving safe low-dose aspirin treatment for primary prevention may continue to do so until more information becomes available, unless new risk factors for aspirin-related bleeding emerge.