Aspirin Withdrawal May Pose Risk To Coronary Patients

Science Daily ^ | 10-30-2003

[blam]

Source: American College Of Chest Physicians
Date: 2003-10-30

Aspirin Withdrawal May Pose Risk To Coronary Patients

(Orlando, Florida, October 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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CHEST 2003 is the 69th annual international scientific assembly of the American College of Chest Physicians, being held in Orlando, October 25-30. ACCP represents more than 15,700 members who provide clinical respiratory, critical care, and cardiothoracic patient care in the United States and throughout the world. ACCP's mission is to promote the prevention and treatment of diseases of the chest through leadership, education, research, and communication.

[blam]

I take 81mg of aspirin a day.

[steplock]

I believe they are mis-characterizing the cause/effect.

It is the APSPIRIN that is keeping the patients healthier.

It is NOT a "withdrawl" effect - "Withdrawl" implies the heart attacks, strokes, etc are caused by the aspirin.

WHAT or WHO is backing this "study" ??

[Reeses]

Thanks for posting. I wonder how researchers determined the 81 mg dosage. Shouldn’t body weight / blood volume be a big factor? I've been taking 3 x 325mg of aspirin daily, 975mg total, for the last 20 years, long before this number came out. Other than a few colds I've had perfect health. Now I know to avoid withdrawal. Aspirin has many benefits, not just heart disease. It reduces the risk of some cancers, such as colon cancer. I’d rather have a quick heart attack than die from that.

[blam]

I've read studies that say there's no benefit above 81mg a day. Don't remember the details though.

[FrankR]

"WHAT or WHO is backing this "study" ??"

Probably the people who make Plavix.

[Reeses]

81 sounds scientific but I’m staying skeptical. Really, how is 1 extra mg over 80 going to help? Did they tack on one to make it sound more precise than it is? I don’t understand how one size fits all, and for all purposes.

[bmwcyle]

I take one 81 mg a day. I am 49 and just had a heart scan. I had zero build up in the arteries. I am going to continue to take them.

[NautiNurse]

One of the studies indicated that the carviovascular therapeutic effect of aspirin (ASA)is reached at 1/20 of a single 325mg aspirin tablet.

Children's chewables ASA (available in cherry flavor!) are 81mg, and much more manageable than chopping up a 325mg tab.

[Dan(9698)]

>>>...Really, how is 1 extra mg over 80 going to help?

Reminds me of an old commercial -- "just a silly millimeter longer-- 101"

[sticker]

After I had 6-bypasses the docs have me on asprin and not Plavix. I hope they know what they are doing!

[bmwcyle]

Beyer has an adult 81 mg on the shelf above the children CVS 81 mg at half the price.

[blam]

"Beyer has an adult 81 mg on the shelf above the children CVS 81 mg at half the price."

What does CVS stand for? BTW, aspirin is aspirin, that's it.

[bmwcyle]

It is just the stores name. It use to be People's Drug.

[bmwcyle]

It is just the stores name. It use to be People's Drug.

[William Tell]

I believe that there was a similar study which indicated that persons who are admitted to a hospital due to a coronary event should continue to take their statin prescriptions.

The theory seems to be that the statins not only reduce LDL levels to reduce coronary artery disease, but that the statins may also have a vessel dilation effect. Cessation of statins may cause a reversal of such dilation and can worsen the event.

The conclusiveness of the study was somewhat in question because there were so many uncontrolled variables. Nevertheless, I believe that the recommended practice is now to continue adminstration of statins.

The magnitude of the apparent effect is such that the entire benefit derived from statin therapy can be reversed almost immediately.

Unfortunately, this is just another complicating factor to make decision-making harder for the average patient.

[Old Professer]

I take 1400 mg dissolved in 1/8 tsp baking soda and 1 ounce of water with a water chaser each day.

[B Knotts]

Heh. 81mg is 1-1/4 grains, which is what the dose was originally.

[NautiNurse]

Beyer has an adult 81 mg on the shelf above the children CVS 81 mg at half the price

I've seen the adult 81 mg located near store brand children's flavored 81 mg ASA--and chuckled at the higher cost for the "adult" ASA.

Build it, package it, advertise it, and they will tear it from the shelves...

[RightWhale]

Aspirin interferes with the clotting mechanism. Bleeding is therefore easier with aspirin and intestinal bleeding is common with overdose.
That's what they mean by 'thinning' the blood. Small clots are discouraged from forming in places with small arteries such as the heart, the lungs, and the brain. A good clot in any of those places can easily be fatal, and in fact is a very common cause of death.

[bert]

I take a 325 each day. My doc said to take this dosage and it had no side effects.

I also carry a small tin with two 325 tablets to take immediately on onset of any significant symptoms..... I don't leave home with out it.