Navigation Links
Lack of aspirin before angioplasty linked with higher mortality
Date:3/7/2013

SAN FRANCISCO (March 7, 2013) Despite recommendations from leading medical groups, a surprising number of patients are not given aspirin before artery-clearing coronary angioplasty and stenting, and those patients have a significantly higher in-hospital death rate, according to research from a Michigan network being presented at the American College of Cardiology's 62nd Annual Scientific Session.

Aspirin use before angioplasty is a Class I recommendation of the American College of Cardiology and American Heart Association, the highest level of evidence for ACC/AHA guidelines. Aspirin has well-documented anti-platelet activity in reducing the risk of cardiac events.

Researchers evaluated registry data for 65,175 patients who had angioplasty and stenting, a percutaneous coronary intervention or PCI, at one of 42 hospitals enrolled in the Blue Cross Blue Shield of Michigan Cardiovascular Consortium PCI Quality Improvement Initiative from January 2010 through December 2011. Of these, 4,640 patients, or 7.1 percent, did not receive aspirin as recommended within 24 hours before PCI. Roughly 90 percent of the non-aspirin patients had no documented barriers to aspirin. Records did show that aspirin was withheld from some patients who had a history of gastrointestinal bleeding, even though such a history usually does not preclude pre-PCI aspirin.

"Our study is not designed to confirm a direct causal effect of aspirin use on PCI outcomes, but [rather] to examine any association with worse outcomes," said Mohamad Kenaan, MD, a cardiovascular medicine fellow with University of Michigan Health Systems, Ann Arbor, Mich., and the study's lead investigator. "Moreover, it highlights an unexpectedly significant number of patients undergoing PCI without receiving aspirin, despite the lack of a documented contraindication in the majority of caseseven in institutions that are active participants in an ongoing quality improvement initiative."

The in-hospital mortality rate of 3.9 percent for the non-aspirin group was considerably higher than the aspirin group's 1.2 percent, and the disadvantage remained after adjustment for confounding bias: death, 3.9 vs. 2.8 percent and stroke, 0.5 vs. 0.1 percent. Those findings held across subgroups, including gender, age, type of coronary artery disease presentation and diabetes. The exception was cardiogenic shocka state that presents challenges for use of oral medicines like aspirin. There was no difference between the groups in bleeding, need for transfusions or kidney damage caused by imaging contrast agent.

Additional data analysis will address other subgroups, hospital length of stay and bleeding. The registry does not contain post-discharge data for longer-term follow-up.

"The strong association our study demonstrated between aspirin non-use before PCI and worse outcomes, including in-hospital death, across all types of ischemic heart disease should be used as a platform for more studies to confirm our findings and motivate quality efforts focused on optimizing aspirin use before PCI," Dr. Kenaan said. "Our findings also may indicate lack of adherence to other guidelines, thus leading to worse outcomes."


'/>"/>

Contact: Beth Casteel
bcasteel@acc.org
240-328-4549
American College of Cardiology
Source:Eurekalert

Related medicine news :

1. Skipping Aspirin Before Artery Procedure May Boost Death Rates
2. Study Links Long-Term Aspirin Use With Vision Loss
3. Long-Term Aspirin Use Linked With Vision Loss: Study
4. Resistance to low-dose aspirin therapy extremely rare
5. Aspirin May Reduce Risk of Liver Cancer, Death From Liver Disease
6. Daily Aspirin May Help Those at Risk for Recurrent Blood Clots
7. Daily Aspirin May Bolster Aging Brain, Study Shows
8. Genes May Determine Aspirins Effect on Advanced Colon Cancer
9. Gene mutation identifies colorectal cancer patients who live longer with aspirin therapy
10. Adding Plavix to Aspirin Doesnt Help Guard Against Second Stroke: Study
11. Aspirin may help men with prostate cancer live longer, study suggests
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/20/2017)... ... June 20, 2017 , ... Hayes, Inc., a ... new eBook titled “ 5 Questions to Ask Before Entering the Maze of ... Genetic Test Evaluation (GTE) team, the book explores the various types of the ...
(Date:6/20/2017)... ... June 20, 2017 , ... EdChoice and ... of school choice can promote economic development in economically distressed urban areas. The ... to the report, contributed to the economic development of the city of Santa ...
(Date:6/20/2017)... ... 20, 2017 , ... MindTouch , the leading provider ... to announce Touchpoints integrations. MindTouch Touchpoints easily integrate product documentation with ... provide a seamless customer experience. , Truly “plug and play,” Touchpoints are easily ...
(Date:6/20/2017)... (PRWEB) , ... June 20, 2017 , ... As a ... on the link between stroke and gum disease. Those with bleeding gums in Vancouver, ... left untreated, this condition can lead to heart disease, stroke and diabetes. Drs. Parviz ...
(Date:6/20/2017)... ... 20, 2017 , ... This year, participants in the Institute ... product improvements that could reduce the occurrence of unplanned extubations (UEs). , ... or to provide medication. Sometimes, patient movement can cause unplanned extubations which is ...
Breaking Medicine News(10 mins):
(Date:6/14/2017)...  In 2016, Embodied Labs took top ... and came away with $25,000 in seed-fund investment. Embodied ... as "entering the life of another" and by the ... to medical professionals in an entirely new dimension." Building ... finalist for the Department of Education,s EdSimChallenge, where they ...
(Date:6/12/2017)... -- Kineta, Inc., a biotechnology company focused on the development ... of R&D and Head of Virology Kristin Bedard has been ... Northwest and Beyond meeting sponsored by Life Science Washington. ... 8:30-10:30 AM PDT at the Agora Conference Center in ... will be joined by other leaders in infectious disease research ...
(Date:6/10/2017)... Ala. , June 9, 2017  Shane K. Burchfield, DPM, ... recognized for excellence as a Podiatrist in Alabama ... Podiatry at Family First Foot Care. He brings over 20 years ... medicine, pain management and healthcare, to his role. ... First Foot Care, PC is pleased to welcome you ...
Breaking Medicine Technology: