ESC: Adverse Outcomes Increased With Suboptimal Adherence to Aspirin After MI

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Risk increased for recurrent MI, ischemic stroke, or death with suboptimal adherence through eight years after MI

By Elana Gotkine HealthDay Reporter

MONDAY, Aug. 28, 2023 (HealthDay News) — Suboptimal adherence to aspirin after myocardial infarction (MI) is associated with an increased risk for recurrent MI, ischemic stroke, or death, according to a study presented at the European Society of Cardiology Congress, held Aug. 25 to 28 in Amsterdam.

Anna Meta Kristensen, M.D., from Bispebjerg and Frederiksberg Hospital in Denmark, and colleagues examined the effectiveness of adherence to long-term aspirin therapy at different timepoints following MI using Danish nationwide registries. Patients aged 40 years and older with a first time MI undergoing percutaneous coronary intervention from 2004 to 2017 who were alive and had stayed adherent to aspirin therapy at one year after the index event were included (40,114 individuals). Adherence to aspirin therapy was assessed as the proportion of days covered (PDC) ≤80 and >80 percent at two, four, six, and eight years after MI.

The researchers found an increase in suboptimal adherence to aspirin from 10 to 19 percent at two and eight years after MI. For both adherence groups, the standardized absolute risk for death, recurrent MI, or ischemic stroke was highest at two years after MI (8.34 and 10.75 percent for PDC >80 and ≤80 percent, respectively). At all timepoints of follow-up, the standardized relative risk for the composite endpoint was significantly higher for patients with PDC ≤80 percent. From four years after MI and onward, there was a trend toward a decreasing protective effect of long-term aspirin therapy, decreasing from 1.40 at four years to 1.20 at eight years after MI.

“The results support current guidelines recommending long-term aspirin after a heart attack,” Kristensen said in a statement.

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