Early aspirin in heart attacks
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Patients who have had a heart attack are more likely to survive if they take aspirin BEFORE they take 'clot-busting agents' which are medicines that dissolve blood clots in the coronary arteries rather than in the reverse order.According to researchers of Sheba Medical Centre in Tel-Hashomer, Israel although it is not clear why the order makes a difference the reduction in mortality may indicate that aspirin improves the restoration of blood flow to the heart. The investigators looked at data from a study of 1200 patients who had at one time or another suffered a heart attack. This study had originally been designed to compare two different types of clot dissolving agents. All the patients were being treated with thrombolytic or clot busting agents.70% (836) of these took aspirin after the clot busting agents ("late users") and 30% (364) took them before ("early users"). The 'early' users took aspirin within the first 1-6 hours of onset of symptoms of a heart attack. The 'late' users took it after having had other drugs and about 3-5 hours after the onset of symptoms. Overall it was found in this study that the 'early' users were more likely than the 'late' users to be alive after their heart attack.The researchers also took into account 35 years of study on aspirin and heart health. High Risk" people were defined as those with: high cholesterol levels, high blood pressure, men over 40 yrs. of age, postmenopausal women, smokers and people with diabetes. Data pooled from several other studies showed that treatment with aspirin reduced the risk of coronary heart disease by 28%. These findings are important in light of the fact that more than 10% of heart attack patients are not given aspirin even though it has been found that the higher the risk of a heart attack the higher the indication for aspirin.
BMJ March 2002, Vol. 324(561)
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