Newswise — A new Mayo Clinic study
provides further evidence of aspirin’s benefits for patients with
heart disease and suggests they should continue taking it even in
the days leading up to surgery.
“Aspirin reduces clotting of the blood,
so it can help prevent a heart attack or stroke by making it less
likely a clot will form and block an already narrowed artery,”
explains R. Scott Wright, M.D., the Mayo Clinic cardiologist who led
the study.
“However, many surgeons who are concerned about excessive
bleeding due to inadequate clotting have advised their patients to
stop taking aspirin in the days before their operation. We designed
this study to provide guidance on whether continuing aspirin therapy
in the days before surgery is beneficial or risky.”
The researchers collected data from
1,636 patients who had first-time coronary artery bypass surgery at
Mayo Clinic in 2000, 2001 and 2002. Patients were divided into two
groups: those who had taken aspirin within the five days before
surgery (1,316 patients), and those who had not (320).
Characteristics of the two groups were similar, except patients in
the aspirin group were more likely to have had a previous heart
attack, while those not taking aspirin were more likely to be on
dialysis.
All members of both groups received aspirin therapy
following surgery, starting six hours after their operation.
Results
The in-hospital mortality for the
aspirin group (1.7 percent) was significantly less than that for
those not receiving aspirin (4.4 percent), and there was no
increased risk of reoperation for excessive internal bleeding.
The study results suggest a reduction in
strokes and related events, but the trend was not strong enough to
be statistically significant.
“This is a very strong association of
survival with taking aspirin in the days leading up to surgery,”
says Dr. Wright. “The study further confirms aspirin’s benefits for
patients with known cardiovascular disease. It also shows there is
no increased risk of bleeding, which eliminates the main reason why
physicians and surgeons would ask patients to discontinue aspirin
therapy. Patients with heart disease who are not taking aspirin
should ask themselves -- and their doctors -- ‘Why not?’”
The findings are published this week in
Circulation: Journal of the American Heart Association. Other
co-authors include Kevin Bybee, M.D., Brian Powell, M.D., Uma Valeti,
M.D., A. Gabriela Rosales, M.S., Stephen Kopecky, M.D., and Charles
Mullany, M.B. M.S.
The study was funded by Mayo Clinic’s
Division of Cardiovascular Diseases. Dr. Wright has previously
received research grant support from Bayer Pharmaceuticals.
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