The link between aspirin and heart attacks: friend or foe?

This study focused on analyzing the association between risk and long-term discontinuation of aspirin versus its effect. continued use after a heart attack. For this purpose, the researchers used information from the national health records of Denmark. The sample included patients from 40 years or more who experienced their first heart attack between 2004 and 2017, underwent coronary stenting, and were on prescribed aspirin treatment within the first year after the heart attack.

One of the unexpected results for the researchers was that many patients did not follow the proper aspirin regimen or stopping treatment. Aspirin adherence was assessed two, four, six, and eight years after infarction. Those patients who took aspirin in 80% or less of the specified time they were classified as non-compliant with the established aspirin protocol.

The study involved 40,114 patients with a first myocardial infarction. Adherence to aspirin treatment gradually declined at each time point, from 90% at two years after MI to 84% at four years, 82% at six years, and 81% at eight years.

What was the result? At each time point assessed, patients taking aspirin as indicated were less likely to experience adverse events compared to those who were not adherent. In patients who do not comply with the recommendations, it was observed 29%, 40%, 31% and 20% increase the probability of recurrent myocardial infarction, cerebrovascular accident or death two, four, six and eight years after a heart attack, respectively.

Despite these results, and because the study is based on a registry, the researchers note that “we do not have information about the specific reasons why patients did not take aspirin.” In addition, our results cannot be generalized to all patients who have had a myocardial infarction because our study focused specifically on those who received coronary stenting and were not taking other medications. With this in mind, the results support the current recommendations that recommend long-term aspirin after a heart attackChristensen concludes.

Of course, this study is important because for several years there has been a debate in the medical community about relevance of long-term treatment with acetylsalicylic acid, the main component of aspirin, in various cardiovascular diseases. Thus, studies of this type provide evidence that this approach may have a positive effect on the prognosis of patients who are particularly susceptible, although questions remain about its harm to healthy people.

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