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Oct 03, 2013

Aspirin Underutilized in Angioplasty Patients

Despite its protective effects, many patients undergoing angioplasty don’t receive aspirin.

Despite guidelines recommending aspirin use before angioplasty, a life-saving procedure that helps open vessels that supply blood to the heart, many patients don’t receive this precautionary therapy, according a recent study.

Aspirin is a simple yet important way to help prevent complications during and after angioplasty. Guidelines from major health organizations—the American College of Cardiology, American Heart Association and European Society of Cardiology—all recommend that patients should take aspirin within 24 hours of undergoing this procedure, mainly because it helps prevent clots and reduce inflammation. The only reason patients should not receive this preventive therapy is if they’re at increased risk for bleeding—the most common type of complication associated with aspirin and other blood-thinners. But data suggests that it’s not just these select, high-risk patients who forego aspirin before angioplasty.

In a study published in the Journal of the American College of Cardiology, researchers identified more than 65,000 patients who underwent angioplasty at 44 Michigan hospitals between 2010 and 2011. After reviewing their medical records, researchers found that 7% (4,640) of these patients did not receive aspirin within 24 hours before undergoing their procedure. Not surprisingly, these individuals had significantly greater risk of stroke and death compared to those taking aspirin. So why did certain patients skip out on aspirin use?

Of course, certain patients had risk factors like increased bleeding risk that prevented them from taking aspirin—but that only accounted for 10% of the patients not receiving pre-procedure aspirin. Also, about 58% of patients not receiving aspirin underwent emergency angioplasty after suffering a heart attack, so there may not have been time to administer aspirin in advance. But about one-third of patients who didn’t receive aspirin underwent a non-emergency angioplasty. That means that there was plenty of time to administer aspirin within 24 hours of the procedure, per medical guidelines.

Investigators admit that medical records were not necessarily optimal for this study, but they hope their findings encourage future research on this topic. Aspirin can help drastically improve outcomes for patients undergoing angioplasty and as guidelines suggest, it should be taken in advance of the procedure whenever possible. Not only do we need to better understand aspirin utilization, efforts should be focused on achieving optimal aspirin use to make angioplasty as safe as possible for patients.

Read the full article in the Journal of the American College of Cardiology

Questions for You to Consider

  • What is angioplasty?
  • Angioplasty (also called percutaneous coronary intervention) is often recommended for patients diagnosed with diseased arteries of the heart (coronary arteries) or for patients suffering a heart attack. Angioplasty includes a variety of procedures developed to compress fat and cholesterol build-up in the arteries, known as plaque deposits, to help increase the size of narrowed or blocked arteries and improve blood and oxygen flow to the heart.
  • Why is angioplasty done?
  • Angioplasty is used to open narrowed or closed arteries that lead to the heart. Angioplasty is most commonly used to treat heart attack or to help prevent a heart attack in patients with plaque build-up.

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