Heart attack patients who fail to adhere to their prescribed aspirin regimen are at a higher risk of experiencing another heart attack, stroke, or even death, according to a study presented at the ESC Congress 2023. The research, conducted by Dr. Anna Meta Kristensen of Bispebjerg and Frederiksberg Hospital in Denmark, emphasizes the importance of following aspirin guidelines post-heart attack until further clinical evidence suggests otherwise.
Aspirin is typically recommended after a heart attack as it helps prevent blood clot formation, subsequently reducing the risk of subsequent heart attacks or strokes. However, with advancements in treatment and diagnosis, the long-term effects of aspirin have become less apparent. In addition, aspirin also carries a risk of increased bleeding, and the balance between its cardiovascular benefits and potential bleeding hazards changes over time after a heart attack.
The study analyzed data from Danish registries and included patients aged 40 years and older who had experienced their first heart attack between 2004 and 2017. These patients had undergone coronary stent treatment and diligently followed their aspirin prescription during the first year after the heart attack. Patients who were on anticoagulants or had experienced a stroke or recurrent heart attack within the first year were excluded from the study.
Adherence to the prescribed aspirin regimen was evaluated at two, four, six, and eight years after the heart attack. Patients who had taken aspirin for 80% of the time or less were considered non-adherent, while those who had taken it for more than 80% of the time were considered adherent. The study revealed a progressive decline in aspirin adherence over time, with rates dropping from 90% at two years following the heart attack to 84% at four years, 82% at six years, and 81% at eight years.
The findings demonstrated that patients who consistently adhered to their aspirin prescription were less likely to experience another heart attack, stroke, or death compared to those who did not. At each time point, non-adherent patients had a significantly higher likelihood of experiencing these adverse events, with a 29% to 40% greater risk compared to adherent patients.
It is important to note that the study only applied to patients who received coronary stent treatment and were not concurrently taking other medications to prevent blood clot formation. The researchers caution that the study’s registry-based nature limits their knowledge about the specific reasons for patients’ non-adherence to aspirin. Moreover, the results should not be generalized to all heart attack patients but are indicative of the importance of long-term aspirin use as recommended in current guidelines.
In conclusion, the study highlights the significant risk associated with discontinuing long-term aspirin use after a heart attack. Until further evidence emerges from randomized controlled trials and clinical guidelines are updated, it is crucial for heart attack survivors to adhere to their aspirin regimen as prescribed. By doing so, they can lower their chances of experiencing another heart attack, stroke, or even mortality.
