Study: Aspirin Doesn't Prevent First Heart Attack in Older Patients

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No First Heart Attack Prevention with Aspirin
No First Heart Attack Prevention with Aspirin

(HealthDay News) — Daily low-dose aspirin therapy may not have significant heart-health benefits for older people, according to a new Japanese study published online November 17 in the Journal of the American Medical Association. The findings were released to coincide with presentation at the annual meeting of the American Heart Association, held from November 15–19 in Chicago.

Kazuyuki Shimada, MD, of the University of Shin-Oyama City Hospital in Tochigi, Japan, and colleagues randomly prescribed daily low-dose aspirin to 14,464 older patients (60–85 years) with hypertension, dyslipidemia, or diabetes. They then tracked the patients to see whether they would experience fewer myocardial infarctions or strokes compared with similarly high-risk patients who weren't taking aspirin. A monitoring committee stopped the study early because there were too few myocardial infarctions or strokes for the researchers to make statistically significant observations. On average, patients were tracked about five years.

Shimada noted during his presentation that "the possibility that aspirin does have a beneficial effect cannot be excluded," given the early end of the trial. But the findings did show no significant difference in deaths, myocardial infarctions, and strokes for people taking aspirin, he said. Shimada added that there appeared to be a trade-off in risks: People who didn't take aspirin were at increased risk of transient ischemic attacks and angina, while people taking aspirin were more likely to experience dangerous bleeding.

"Patients need to discuss this with their doctor, because I think it's difficult to do that calculation of benefit and risk without consulting a health care professional," Michael Gaziano, MD, MPH, from Brigham and Women's Hospital in Boston, who coauthored a commentary accompanying the study, told HealthDay. Gaziano doesn't believe the findings will have much of an impact on current U.S. guidelines regarding aspirin. That's due to limitations of the study, and differences between Japanese and American populations, he said.

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