What a UK aspirin study found
Daily aspirin users might need a PPI
Published 14 June, 2017
Elderly patients taking daily aspirin after a stroke or MI (heart attack) should be given PPIs (Proton Pump Inhibitors) to reduce the risk of bleeding.
This is the conclusion of a Lancet study of 3166 patients, which found the risk of internal bleeding is far higher than was previously thought.
Compared with younger patients, older aspirin users were 10 times more likely to experience disabling or fatal gastrointestinal bleeding, the research shows.
The proportion of study participants suffering bleeds that required hospital admission rose from 1.5% a year for those under 65 to 3.5% for those aged 75-84.
For very elderly patients, over 85, the annual bleed rate reached 5%.
Doctors are now being advised to prescribe PPIs alongside aspirin to reduce the risk.
While it’s been known for some time that aspirin increases the risk of bleeding for elderly patients, this study provides a much clearer understanding of the size of the increased risk, and the severity and consequences of bleeds.
“Our findings raise questions about the balance of risk and benefit of long-term daily aspirin use in people aged 75 or over if a proton-pump inhibitor is not co-prescribed,” says lead author Professor Peter Rothwell from the University of Oxford.
Most of the patients in the study were taking low-dose (75mg) aspirin.
Only a few were being treated with a different drug, clopidogrel. It was not known if the findings applied to other blood-thinning drugs. – PA