Diabetes, Heart and Cardiovascular Diseases News Chronicle.  Diabetes, Cardiovascular and Heart Diseases
 Article 330
    Published on May 19, 2018

Aspirin lowers risk of death but may increase non-fatal heart attack or stroke risks

In the United States, about 27 million people are with type 2 diabetes and about 6.5 million people are with heart failure (HF) condition. Formation of thrombosis (blood clots) is common among people with type 2 diabetes. Earlier studies show both type 2 diabetes and heart failure conditions are linked with increased blood clotting activity.

Healthcare professionals recommend aspirin pill, a blood-thinning drug, to those patients who have suffered a heart attack (myocardial infarction MI) or stroke. But there are no clear guidelines on the usage of aspirin pill among patients without the heart attack or stroke history but having cardiovascular risk factors.

Earlier studies on the benefits of aspirin medication among patients without the heart attack or stroke history are conflicting. Some studies found daily aspirin drug usage may be harmful to heart failure patients.

A large observational study supported by the Biomedical Research Program at the Weill Cornell Medicine-Qatar shows taking aspirin drug daily can extend life and reduces the risk of death among patients with both type 2 diabetes and heart failure conditions. This study also found that the aspirin may increase non-fatal heart attack or stroke risks in those patients. This was the first study to assess the aspirin pill as a preventive medication for patients with both type 2 diabetes and heart failure (HF) conditions.

Researchers have conducted analytical studies on 12,534 patients. About 6,000 patients are taking aspirin pill daily. Participants were aged 55 years or older with both type 2 diabetes and heart failure condition but without any other heart disease events history such as peripheral artery disease (PAD), heart attack, stroke or atrial fibrillation (AFib).

Those patients taking aspirin dose of more than 75 mg daily were tracked for events such as hospitalization for heart failure and all-cause mortality as a composite primary outcome. As secondary outcomes, they were tracked for events such as major bleeding events and nonfatal heart attack (nonfatal myocardial infarction MI) or stroke, hospitalization for heart failure and all-cause mortality.

Researchers have used The Health Improvement Network (THIN) data for the study purpose. This data contains patient's information collected from over 550 general practitioners in the United Kingdom.

A five-year follow-up study on patients taking daily aspirin pill when compared with patients not taking aspirin pill shows following results.

The health event Associated effect with aspirin
The primary outcome 10% decrease, mainly all-cause mortality
Major bleeding events No difference
Non-fatal heart attack (myocardial infarction MI) or stroke 50% increase
There are no extra benefits with more than 75mg aspirin dose.

Researchers say patients should consult their physicians to determine the risks and benefits of taking aspirin tablet. They suggested that a physician should use an established cardiovascular risk calculator to determine future risks of the patient before prescribing aspirin therapy to a patient. Authors say their study was a preliminary study and further studies are required to confirm their study findings.

Aspirin drug pill lowers risk of death mortality but increases heart attack stroke risks in patients.

These study findings were presented at the 67 th Annual Scientific Session - 2018 of the American College of Cardiology (ACC) March 10 - 12 at Orlando, Florida, the United States of America. Lead author of the study was Dr. Charbel Abi Khalil, MD, PhD, FESC, FACC, FAHA, an assistant professor of medicine at the Weill Cornell Medicine, Qatar. The study findings were published March 2018 in the Journal of the American College of Cardiology. Title of the article was "Primary prevention with aspirin reduces mortality in type 2 diabetes and heart failure : Results from the thin primary care database." DOI : doi.org/10.1016/S0735-1097(18)32392-1

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Acute coronary syndrome : A sudden reduction in the blood flow to a part of heart muscles due to multiple heart disease conditions.

Pericarditis : Inflammation in the fibrous sac surrounding the heart.

Aspirin : This is a non-steroidal anti-inflammatory drug (NSAID). This drug is also known as acetylsalicylic acid (ASA). This drug is a blood thinner and also a pain reliever. It is used for the treatment of headaches, colds, period pains, flu, pains, sprains, strains, arthritis, inflammatory joint conditions, fever or specific inflammation conditions such as Kawasaki disease (an autoimmune disease), pericarditis, rheumatic fever and colorectal cancer.

Aspirin also reduces the risk of blood clot (thrombosis) formation and damage to the heart (or cardiac) tissue. This drug can be given shortly after the heart attack to reduce the risk of death or mortality. Long term usage can also help heart disease patients in preventing myocardial infarction (heart attack), stroke, chest pain (angina) and blood clots.

This drug may be given to following people.

This drug is not recommended to following people.

  • Children or teenagers with infections, flu symptoms, fever or chicken pox.
  • Women who are in the last part of pregnancy.
  • Breastfeeding women (as aspirin may harm nursing baby).
  • People with bleeding disorders such as hemophilia, stomach or intestinal bleeding.
  • Patients who are allergic to a non-steroidal anti-inflammatory drug (NSAID).
  • Peptic ulcer patients.
  • To those patients who are undergoing dental or surgical treatment.

The stomach upset is a common adverse effect with this drug. Other significant side effects are

  • Stomach bleeding.
  • Stomach ulcers.
  • Worsening asthma.
  • Stomach or gut irritation or inflammation.
  • Indigestion.
  • Nausea.
  • Hemorrhagic stroke risk.
  • Blood bleeding risk among following people.
    • Older people.
    • Those people who consume alcohol regularly.
    • Patients who are using other NSAIDs or blood thinning drugs.



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