Aspirin Safe for Heart Failure Patients, Study Finds

Amy Norton wrote . . . . . .

Some research has raised concerns about the safety of aspirin for heart failure patients. But a new study appears to offer some reassurance.

The study, of over 2,300 patients, found that those on daily aspirin were not at heightened risk of being hospitalized for, or dying from, heart failure.

That has been a concern because, in theory, aspirin could interfere with the benefits of certain heart failure drugs, explained Dr. Shunichi Homma, the senior researcher on the study.

Plus, two past studies have linked aspirin use to an increased risk of heart failure complications.

But the new study, which compared aspirin to warfarin, a blood thinner, was larger and longer-term — following patients in 168 centers in 11 countries over 10 years.

“I think this should allay fears that there might be a detrimental effect of prescribing aspirin,” said Homma. He is deputy chief of cardiology at New York-Presbyterian/Columbia University Medical Center, in New York City.

Homma and his colleagues reported the findings in the July 31 online issue of JACC: Heart Failure.

Dr. Christopher O’Connor is a cardiologist and editor-in-chief of the journal.

He agreed that the findings are reassuring. Compared with the earlier, smaller studies, O’Connor said, “this one is probably closer to the truth.”

O’Connor said he thinks the results have “immediate implications” for heart failure care.

Close to 6 million Americans have heart failure, according to the U.S. Centers for Disease Control and Prevention.

It’s a chronic condition in which the heart muscle can no longer pump blood efficiently enough to meet the body’s needs. That causes symptoms such as fatigue, breathlessness and swelling in the limbs.

Often, heart failure is caused by damage to the heart muscle from a heart attack or coronary artery disease. And, in general, those patients should be on aspirin to limit the risk of a first-time or repeat heart attack, O’Connor said.

The trouble is, there have been concerns that aspirin could interfere with ACE inhibitors or angiotensin receptor blockers (ARBs) — two drug classes that are key in managing heart failure. Those drugs boost compounds called prostaglandins in the blood, whereas aspirin reduces them.

For the new study, Homma’s team analyzed data from a clinical trial in which heart failure patients were randomly assigned to take either aspirin or warfarin, which is used to prevent blood clots.

Patients in the aspirin group took 325 milligrams per day.

Over 10 years, just over 19 percent of aspirin patients were hospitalized for heart failure, or died of the disease. That compared with just under 23 percent of warfarin users, the findings showed.

Homma’s team also accounted for other factors, including patients’ age and heart disease severity. In the end, there was no statistical difference between the two groups in their risk of heart failure complications.

To O’Connor, the bottom line for heart failure patients is straightforward: “If you’re on aspirin for a guideline-recommended indication,” he said, “keep taking it.”

Of course, aspirin is not without risks. It can cause bleeding in the digestive tract, or even contribute to a hemorrhagic (bleeding) stroke.

So patients should never take aspirin on their own, without a doctor’s guidance, Homma said.

Dr. Susan Graham, a cardiologist who also worked on the study, made a broader point: Heart patients — and older adults, in general — are often taking many prescription drugs at any given time.

“That speaks to the importance of studying potential drug interactions,” said Graham, a professor of medicine at the University at Buffalo, in New York.

“We have to stay on our toes to make sure that we’re doing the right thing,” she said.

Homma and some of his colleagues on the study reported receiving research funding or fees from the pharmaceutical industry.

Source: HealthDay


Before Using Aspirin to Lower Your Risk of Heart Attack or Stroke, What You Should Know

Only a health care provider can determine whether regular use of aspirin will help to prevent a heart attack or stroke in your particular case. Aspirin can prevent these problems in some people but not in everyone, and it has important side effects. You should use daily aspirin therapy only after first talking to your health care provider, who can weigh the benefits and the risks.

Aspirin is often thought of as a harmless over-the-counter (OTC) drug that’s been relied on for years to treat pain and fever. Now you’re hearing that it can also lower your risk of a heart attack and some kinds of strokes. Aspirin may seem like a quick-and-easy way to decrease these risks, but it’s not as simple as you think.

What Studies Show

Since aspirin was discovered more than a century ago, it has played a major role in treating headaches, fevers, and minor aches and pains for millions of people. Now studies show that because aspirin thins the blood, it can also help to lower the chances of a heart attack or a stroke caused by a blood clot in the brain. But research has found it works only in certain people, specifically those who had a previous heart attack or stroke, or have disease of the blood vessels in the heart. It does not seem to work in people with healthier hearts and blood vessels.

Most health professionals agree that long-term aspirin use to prevent a heart attack or stroke in healthy people is unnecessary. If you are using aspirin to lower these risks and have not talked with a health professional about it, you may be putting your health at risk. You should ONLY use daily aspirin therapy under the guidance of a health care provider.

Not Without Risks

Aspirin has been known to help people living with some diseases of the heart and blood vessels. It can help prevent a heart attack or clot-related stroke by interfering with how the blood clots. But the same properties that make aspirin work as a blood thinner to stop it from clotting may also cause unwanted side effects, including bleeding into the brain or stomach.

Aspirin also can mix badly with prescription medicines and over-the-counter drugs. People already using a prescription medicine that thins the blood such as warfarin, dabigatran (Pradaxa) and rivaroxaban (Xarelto) should always talk to a health professional before using aspirin, even occasionally.

Discuss the use of all medicines, vitamins, and dietary supplements with your health professional before taking aspirin daily. He or she will decide if the benefits of taking daily aspirin outweigh the risks in your particular case and can provide medical knowledge and guidance to help prevent unwanted side effects.

Dose Matters

Whatever purpose you are using daily aspirin for, how much you take matters. It’s important to your health and safety that the dose you use and how often you take it is right for you. Your health professional can tell you the dosing and directions that will provide the greatest benefit with the least side effects.

Not all over-the-counter pain relievers contain aspirin. If your health care provider prescribes daily aspirin to lower the risk of a heart attack and clot-related stroke, read the labels carefully to make sure you have the right product. Some drugs combine aspirin with other pain relievers or other ingredients and should not be used for long-term aspirin therapy. If you have questions talk to a health professional.

Before you use aspirin to lower your risk of heart attack and stroke, talk to a health professional. It could save your life.

Source: U.S. Department of Health and Human Services


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