Aspirin
withdrawal may pose risk to coronary patients
Onset of coronary events occur within one week
of aspirin withdrawal
Oct. 29, 2003 -- Patients with coronary artery
disease who stop taking aspirin may be at risk for developing
withdrawal-related coronary events, says a new study presented at
CHEST 2003, the 69th annual international scientific assembly of the
American College of Chest Physicians (ACCP).
The study found that previously stable coronary
patients experienced coronary events, including unstable angina and
myocardial infarction (heart attack), within one week of aspirin
withdrawal.
"The benefits of aspirin therapy in coronary
patients are well known. However, the effects that aspirin withdrawal
has on this group of patients are just now being studied," said lead
author Emile Ferrari, MD, Professor of Cardiology, University Hospital
Pasteur, Nice, France. "Our study shows that aspirin therapy can not
be safely stopped in any case, but especially in patients with a
history of coronary disease."
Researchers from University Hospital Pasteur
reviewed the cases of 1,236 patients hospitalized for coronary
syndromes to determine which patients were hospitalized due to
treatment withdrawal. Of those hospitalized, 51patients experienced
acute coronary events, including unstable angina, stent thrombosis,
and heart attacks, less than one week after aspirin withdrawal. Prior
to hospitalization, patients had been taking aspirin for at least
three months. Although patients had a history of heart attacks and
stable angina, none had an unstable coronary event prior to aspirin
withdrawal. Reasons for aspirin withdrawal included minor surgery,
dental treatment, and non-compliance. Aspirin therapy is standard in
patients with coronary artery disease because of its ability to thin
the blood and reduce the risk of developing acute blockage in the
coronary arteries.
"Coronary patients preparing for dental work or
surgery are often advised to stop taking aspirin in order to avoid
increased bleeding," said Dr. Ferrari. "Our study serves as a reminder
for all medical professionals who treat coronary patients that aspirin
withdrawal should not be advised, and that alternative recommendations
should be considered."
"This study not only reinforces the importance of
compliance with aspirin therapy in coronary patients, but it sends a
message to all medical professionals that the decision to discontinue
aspirin therapy should not be taken lightly," said Richard S. Irwin,
MD, FCCP, President of the American College of Chest Physicians.
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