SECONDARY PREVENTION. THE DANGERS OF STOPPING ASPIRIN

Good old, headache relieving aspirin is good for the heart, especially when we use low dose aspirin to prevent further cardiovascular events following previous heart disease ( secondary prevention ). A new study has shown that if you discontinue your low dose aspirin, when you should be taking it for secondary prevention, you increase your risk of getting another CV event. This was conclusively shown in an epidermiological study by Dr Luis Gracia Rodriguez and colleagues from the Spanish Center of pharmaco-epidermiologic Research, in Madrid Spain. They looked into the UK Health Improvement Network database of 39,513 patients who were on low dose aspirin for secondary prevention. These were patients who were started on low dose aspirin from 2000-2007, aged 50-84 years. Almost half of the patients had stopped their aspirin. They followed those who stopped and those who continued, for about 3 years. They found that of those who stopped, there were an increase rate of CV events. In fact they calculated that for every 1,000 of those who stopped, there were 4 more episodes of heart attacks. Now this is significant. This same findings had been reported before, perhaps in a smaller scale, in major institutional studies.
It is quite important, in our context to emphasize this to our patients, as Malaysian patients have the habit of doctor hopping, default on therapy, changing to traditional medication, or just simply lost to follow-up. We must tell them, after their heart attack, that low dose aspirin will prevent further heart attacks, and if they should discontinue ( except under medical supervision ), they run an increase risk of another heart attack.
I was also hoping to see from this large epidermiologic study, the incidence of gastro-toxicity. It was not mentioned.