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Aspirin Withdrawal Risky in Coronary Patients: Presented at CHEST

By Mike Fillon

ORLANDO, FL -- October 31, 2003 -- Patients who discontinuing the aspirin therapy they were taking to thin blood and prevent coronary blockage might be at risk of developing withdrawal-related coronary events according to a study presented here at CHEST 2003, the 69^th Annual Scientific Assembly of the American College of Chest Physicians.

According to Emile Ferrari, MD, professor of cardiology, University Hospital Pasteur, Nice, France, the study found that previously stable coronary patients experience coronary events, including unstable angina and myocardial infarction, within a week of stopping their aspirin prophylaxis.

"Our study shows that aspirin therapy cannot be safely stopped in any case, but especially in patients with a history of coronary disease," he said.

The study included a review of 1,236 people who were hospitalized for heart attacks and other acute coronary events at University Hospital Pasteur. After reviewing their medical records, the researchers found that, 500 of these patients had been taking aspirin for a heart condition on their doctor's orders. In that subgroup, 51 of them were hospitalized within a week of stopping their aspirin therapy.

Twenty of those patients had stopped taking the aspirin without consulting their physicians, while the rest were told by their doctors' to stop aspirin to avoid potential bleeding problems during medical procedures such as minor surgery and dental treatments. "Coronary patients preparing for dental work or surgery are often advised to stop taking aspirin in order to avoid increased bleeding," said Dr. Ferrari.

The coronary events seen included unstable angina, stent thrombosis and heart attacks -- each within 1 week of aspirin withdrawal. Prior to hospitalization, the patients had been taking aspirin for at least 3 months. Although the patients had histories of heart attacks and stable angina, none had an unstable coronary event prior to aspirin withdrawal.

"Our study serves as a reminder for all medical professionals who treat coronary patients that aspirin withdrawal should not be advised, and that alternative recommendations be considered," said Dr. Ferrari.

The American Heart Association recommends that patients who are told to take aspirin regularly to reduce the risk of blood clots should not stop without consulting a physician.


[Study title: Coronary Syndromes Following Aspirin Withdrawal]

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