Navigation Links
Lack of aspirin before angioplasty linked with higher mortality

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
American College of Cardiology

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:
(Date:10/13/2015)... (PRWEB) , ... October 13, 2015 , ... ... workflow solutions, announced today their sponsorship of the Microsoft Dynamics AXUG, GPUG and ... AXUG Summit, GPUG Summit and NAVUG Summit are independent user conferences designed and ...
(Date:10/13/2015)... ... October 13, 2015 , ... In an age where ... were 36 percent lower per square foot than in 2009. The Williamsport Regional Medical ... heating and cooling has decreased by eight percent. , According to Facilities Management ...
(Date:10/13/2015)... ... October 13, 2015 , ... e-con Systems Inc., a leading embedded ... See3CAM_CU40, the industry’s first RGB-IR pixel format camera with a USB 3.0 interface ... e-con’s See3CAM family of UVC USB 3.0 cameras, is based on the 1/3-inch OV4682 ...
(Date:10/13/2015)... Los Angeles, CA (PRWEB) , ... October 13, ... ... has published an in-depth review of Anik Singal's newly launched "Publish Academy" ... scaling a digital publishing business opened for enrollment today, and marketers around the ...
(Date:10/13/2015)... , ... October 13, 2015 ... ... Omega-3, a first-of-its kind product that targets the unique health needs of ... of the American Pregnancy Association ( ), utilizes Nordic Naturals’ exclusive, ...
Breaking Medicine News(10 mins):
(Date:10/13/2015)... , Oct. 13, 2015  Yesterday Congresswoman ... Vaccines Holly Springs manufacturing site located in ... the facility has produced Flucelvax ® (Influenza Vaccine) using ... potential for faster start-up and is not reliant on ... Limited acquired the influenza vaccines business of Novartis AG ...
(Date:10/12/2015)... 13, 2015 the United States ... a non-clinical capacity. --> the United States ... a non-clinical capacity. --> The University of Texas MD ... the first high field (1.5 Tesla) MRI-guided linear accelerator in ... system will be operating in a non-clinical capacity. Royal ...
(Date:10/12/2015)... , Oct. 12, 2015  Former White House Spokesman, and ... for the House Narcotics Committee, Robert Weiner , and ... Policy." The two emphasize that this is now a potential ... to Jeb Bush , Carly Fiorina to ... the newest federal statistics, which they call "a shocker: 23 ...
Breaking Medicine Technology: