25 Feb Study Finds Aspirin Safe For People Waiting To Have Coronary Artery Surgery
MedicalResearch.com Interview with:
Prof. Paul Myles
Professor Paul Myles MBBS, MPH, MD, FCARCSI, FANZCA, FRCA
Director, Dept of Anaesthesia and Perioperative Medicine
Alfred Hospital and Monash University, Melbourne, Australia
Medical Research: What is the background for this study? What are the main findings?
Dr. Myles: When we set up this study 10 years ago there was marked variation in practice for people taking aspirin waiting for coronary artery bypass surgery. About half were being told that they must stop their aspirin 5-7 days before surgery, and the other half were told that they should stay on their aspirin. This variation existed across different countries, different cities, and even within a single hospital. Doctors had varied opinions because reliable medical research was sparse; the evidence was contradictory. We thus designed a definitive clinical trial in which half the patients were randomly assigned to receive aspirin and the other half received a placebo. Our study has shown that aspirin is safe (i.e. it does not increase the bleeding risk). We also found that there does not appear to be a benefit during and after surgery, but in view of the clear benefits that exist in daily life, including the preoperative waiting period, we recommend that people should stay on their aspirin if they are having coronary artery surgery.
Medical Research: What should clinicians and patients take away from your report?
Dr. Myles: Aspirin is safe for people waiting to have coronary artery surgery.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Myles: Some people are resistant to the protective effects of aspirin. This might be a genetic predisposition and the genes responsible need to be characterized in order to identify people who need modification to their medications to prevent heart attack or stroke. They might benefit from a higher dose, or perhaps another type of blood thinning medication. Each of these should be investigated further.
Medical Research: Is there anything else you would like to add?
Dr. Myles: Heart surgery has become much safer in the past 20 years. Improvements have come about because of medical research, with large, independent clinical trials being the best way to quickly and reliably identify effective treatments. This is essential to advance the safety and practice of healthcare.
Citation:
Stopping vs. Continuing Aspirin before Coronary Artery Surgery
N Engl J Med 2016; 374:728-737
February 25, 2016
DOI: 10.1056/NEJMoa1507688
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Professor Paul Myles MBBS, MPH (2016). Study Finds Aspirin Safe For People Waiting To Have Coronary Artery Surgery
Last Updated on February 25, 2016 by Marie Benz MD FAAD