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Could heart attack sufferers benefit, as much from taking one aspirin a day after heart attack as from taking aspirin along with Coumadin? A team of researchers at Yale say yes.
"There was no difference between the two groups in terms of total mortality, cardiovascular mortality, nonfatal myocardial infarction, and nonfatal stroke," Michael Ezekowitz, M.D., Yale cardiologist and lead investigator of the Combined Hemotherapy and Mortality Prevention Study (CHAMP), told Medical Update. "Aspirin and Coumadin are the two strongest candidates to prevent blood clotting in the coronary vessels after heart attack. The study shows that aspirin is equally effective as the combination."
The six-year CHAMP study included more than 5,000 U.S. veterans. Half received 162 mg of' aspirin, and the other were given 81 mg of aspirin plus Coumadin.
"There is very good evidence that aspirin reduces death after heart attacks and reduces the chance of having a second stroke," says Dr. Ezekowitz. "This is a body of evidence that has been accumulating over the past 20 years. If somebody has chest pain in the middle of the night, the best advice is: Take two aspirin and come into the hospital. It reduces your chances of dying by about 20 percent."
People with irregular heartbeats and those undergoing heart surgery may also benefit from aspirin therapy, according to Dr. Ezekowitz.
"Low-risk patients with atrial fibrillation benefit from aspirin," he says. "These are people usually under the age of 75 who are neurologically normal, have normal heart function, and are without a history of high blood pressure or diabetes. Aspirin is also recommended in combination with a drug called Plavix prior to angioplasty and bypass surgeries."
In other aspirin-related research, Mayo Clinic researchers say that taking ibuprofen for pain relief may block aspirin's heart benefits. Study data published in a recent issue of the New England Journal of Medicine show that one dose of ibuprofen--sold as Advil and Motrin--taken before aspirin reduced aspirin's ability to prevent platelets from clumping. Acetaminophen (Tylenol), rofecoxib (Vioxx) and diclofenac sodium showed no effect on aspirin's effectiveness.
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