NEW YORK, Oct 31, (Agencies): A recent study has challenged the long-standing practice of prescribing extended periods of aspirin to high-risk cardiovascular patients with stents. In some cases, this approach may not only be ineffective but also potentially harmful.

The study, featured in the scientific journal Circulation, examined over 7,500 patients with acute coronary syndrome, a term encompassing various heart conditions, including heart attacks, resulting from a sudden reduction in blood flow to the heart. These patients were undergoing a common medical procedure called percutaneous coronary intervention, which involves using a small balloon to open blocked arteries and inserting a metallic mesh tube, known as a stent, into the coronary artery to maintain blood flow. To prevent blood clot formation after stent placement, a combination of antiplatelet medication and aspirin was typically prescribed for about a year.

However, the research showed that discontinuing aspirin after just three months was equally effective in preventing clotting complications while significantly reducing the risk of severe bleeding, a side effect associated with aspirin.

Dr. Roxana Mehran, the principal investigator of the study and a cardiologist at the Icahn School of Medicine at Mount Sinai, raised questions about the necessity of aspirin in conjunction with other potent medications, suggesting that it could profoundly increase the risk of bleeding without providing substantial benefits.

Cardiovascular diseases remain the leading cause of death globally, responsible for nearly 18 million deaths annually, according to the World Health Organization.

For years, aspirin was widely recommended to prevent heart-related issues due to its blood-clotting inhibiting properties. However, as people age, aspirin usage may elevate the risk of severe bleeding. Consequently, in 2019, the American College of Cardiology and the American Heart Association shifted their stance, no longer advocating daily aspirin for older adults without a high risk of existing heart disease. In 2022, the United States Preventive Services Task Force also recommended against daily aspirin for individuals over 60.

While some health professionals still find aspirin beneficial for patients with heart problems or stents, the recent study's findings challenge this assumption. Pooled patient data from two large clinical trials revealed that patients who ceased aspirin after three months had similar outcomes in terms of death, heart attacks, and strokes when compared to those receiving the aspirin-ticagrelor combination therapy.

Discontinuing aspirin reduced the risk of severe bleeding by almost 50%, without increasing the likelihood of cardiac complications. This discovery could potentially become the new standard of care for high-risk cardiac patients, and there is ongoing research to investigate even earlier discontinuation, perhaps after just one month.

It is important to note that aspirin remains a crucial treatment for heart attacks, particularly in the initial three months following stent placement. The study primarily focused on high-risk patients recovering from acute coronary syndrome who were taking ticagrelor twice a day for at least a year.

The study's results do not apply to patients with other heart conditions, such as atrial fibrillation, which requires blood thinners for treatment.

In summary, while the study has challenged the long-term use of aspirin for certain high-risk cardiovascular patients, aspirin continues to play a significant role in the treatment of heart attacks and should not be discontinued without medical consultation. Furthermore, further research may lead to simplified and more effective medication regimens for these patients.