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Use of Aspirins to Treat Heart Attacks
The Food and Drug Administration (U.S.) is proposing to let doctors prescribe aspirin
for patients to take during suspected heart attacks.
This new use of the drug is based on studies showing that taking as little as half a
regular-strength aspirin tablet as soon as a heart attack is suspected and continuing
the drug for 30 days can significantly reduce the risk of death, experts said.
Dr. Debra Bowen, director of the drug agency's division for over-the-counter drug
products, noted that no one should use the drug for this new indication without
consulting a doctor.
A group of cardiac specialists, led by Dr. Charles H. Hennekens of Harvard Medical
School, has argued that there is strong evidence from several international studies that
aspirin could be beneficial while a heart attack is in progress.
Studies show that aspirin, which is widely available and costs very little, is as
effective as specialized drugs that dissolve the blood clots that cause a heart attack
and the other drugs that cost hundreds of dollars per dose.
A major international study of heart attacks that involved more than 17,000 patients
at 417 hospitals around the world found that aspirin reduced deaths from heart attack
by 23 percent in patients who took the drug within 24 hours of the onset of
symptoms. And when aspirin was combined with specialized drugs during this early
treatment period, deaths decreased by 42 percent.
Since about 50,000 heart attack patients who are hospitalized in the US die from the
condition, general use of aspirin within the first hours of the attack could prevent
5,000 to 10,000 premature deaths each year, said Hennekens*, who is chief of
preventive medicine at Brigham and Women's Hospital in Boston.
Aspirin works against heart attacks by helping to dissolve clots of blood that block
arteries and by preventing further blockages. The drug interferes with the production
of substances called prostaglandins, which promote the clumping of blood cells
called platelets. These cells are essential to the formation of blood clots.
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“All patients suffering from blockage of an artery in the heart or brain should receive 325 mg regular
aspirin promptly and daily aspirin thereafter to reduce their death rate as well as subsequent heart
attacks and strokes,” said Hennekens. In addition, he also stressed that "among long -term survivors of
prior heart attacks, occlusive strokes or blockages in the arteries of the legs, aspirin should be
continued long-term unless there is a specific contraindication."