An aspirin a day has been a standard recommendation for those diagnosed with certain types of coronary disease for decades. However, knowing patients like we do, medication non-compliance is a real problem -especially when it comes to recommended non-prescription drugs. So, what happens if a patient suddenly stops their aspirin regimen?
Well, researchers in Sweden have recently discovered that stopping low-dose aspirin by patients who have already had a heart attack can actually increase their risk by up to 37 percent for having a subsequent MI.
The Problem of Non-compliance
Research led by Johan Sundström, professor of epidemiology at Uppsala University in Sweden examined the medical records of 601,527 people aged 40 and above who took aspirin in low doses to prevent either a first or a second heart attack. They found that around 20 percent of study participants stopped taking aspirin against the advice of the prescribing physician within 1 to 3 years.
The Result of Non-compliance
In the study, it was found those who stopped the aspirin treatment were 37 percent more likely to have an adverse cardiovascular event than those who continued the therapy. This is equal to 1 in every 74 patients who quit aspirin experiencing a heart attack or death due to a cardiovascular event within 5 years.
Of course since this was a retrospective observational study it is difficult to pinpoint causality. However, it is thought that stopping aspirin may cause a rebound effect. This refers to the possibility that stopping aspirin, which has blood-thinning properties, may have blood-clotting effects after discontinuation. Other studies on stroke have supported this theory.
On the clinical implications of these results, Professor Sunström says,
“Adherence to low-dose aspirin treatment in the absence of major surgery or bleeding is likely an important treatment goal.”
Aspirin is a low-cost means that has proven effective in preventing cardiac and ischemic events like stroke due to clots. Education is one way to improve compliance and should be ongoing throughout the patient’s therapy.
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