Adherence to aspirin progressively declined with each time point, from 90% at two years following the heart attack to 84% at four years, 82% at six years and 81% at eight years. The study included 40,114 patients with a first-time heart attack. Therefore, patients undergoing such treatments were excluded from our study.” Both anticoagulants and P2Y 12 inhibitors are agents that, similar to aspirin, work to prevent the formation of blood clots. Kristensen explained: “We assessed the effects of long-term aspirin use in patients who were not receiving other medications for the prevention of heart attack or stroke. At each time point, patients were excluded if they had experienced another heart attack, a stroke, died, or had been started on anticoagulants or P2Y 12 inhibitors.ĭr. Patients on aspirin for 80% or less of the time were considered non-adherent (i.e., not taking aspirin as prescribed) while those on aspirin more than 80% of the time were considered adherent (i.e., taking aspirin as prescribed). Adherence to aspirin at each of the four time points was assessed as the proportion of days patients had their pills over the preceding two years. In Denmark, every time a patient picks up a prescription of aspirin, the number of tablets and date of collection are recorded in registries. Patients who were on anticoagulants or had a stroke or recurrent heart attack within that first year were excluded.Īdherence to aspirin was evaluated at two, four, six and eight years after the heart attack. It included patients aged 40 years and over who had a first-time heart attack from 2004 through 2017, were treated with a coronary stent and took aspirin as prescribed during the first year after their heart attack. The study used data from Danish nationwide health registries. This study investigated the risk associated with discontinuation of long-term aspirin compared with continued use after a heart attack in a contemporary setting. 4,5 Because aspirin prevents the formation of blood clots, it also increases the risk of bleeding, and the balance between the cardiovascular benefits and bleeding changes with time after a heart attack. 2,3 However, as treatment and diagnostic methods have advanced in recent decades, the prognosis after myocardial infarction has improved and the long-term effects of aspirin are now less evident. “We recommend that all patients who have had a heart attack stay adherent to their aspirin in accordance with guidelines until randomised controlled trials have proven otherwise, and clinical guidelines have been changed.”Īspirin is mandatory following a heart attack due its ability to prevent blood clot formation, and thus reduce the risk of a new heart attack or stroke. Anna Meta Kristensen of Bispebjerg and Frederiksberg Hospital. “Our findings suggest that not taking aspirin as prescribed after a heart attack is linked to a higher risk of having another heart attack, a stroke or dying,” said study author Dr. Amsterdam, Netherlands – : Heart attack patients who do not take daily aspirin have an elevated likelihood of recurrent myocardial infarction, stroke or death compared with those who consistently take the drug, according to research presented at ESC Congress 2023.
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