Aspirin reduces death rate in heart patients

NEW YORK (Reuters Health) - In people with stable heart disease, low-dose aspirin reduces the occurrence of heart attacks, strokes, and deaths from all causes, according to a new analysis.

Although aspirin also increases the risk of bleeding, the benefits outweigh the risk, lead author Dr. Jeffrey S. Berger, of the Duke Clinical Research Institute, Durham, North Carolina, and his associates conclude in their report in the American Journal of Medicine.

Unlike previous analyses that combined various populations with treated with different blood-thinning drugs and dosages, the researchers point out, "our study focuses on low-dose aspirin in a population with stable cardiovascular disease."

Berger's group identified six clinical trials that included nearly 10,000 patients with stable heart-related chest pain or a history of heart attack, stroke, or mini-stroke.

Compared to inactive placebo treatment, aspirin therapy was associated with a 13 percent reduction in the odds of dying during follow-up, a 26 percent reduction in the odds of a non-fatal heart attack, and a 25 percent reduction in the odds of stroke.

In a subgroup analysis, low doses of aspirin (50 to 100 milligrams per day) were shown to be as effective as a higher dose (300 milligrams per day).

Although long-term aspirin therapy doubled the risk of major bleeding, Berger's group notes that the absolute risk was still low.

They calculate that among 1000 patients, low-dose aspirin would prevent approximately 33 heart attacks or stroke and 14 deaths, and cause approximately 9 episodes of serious bleeding -- a worthwhile trade-off.

SOURCE: American Journal of Medicine, January 2008.