Asa-p after surgery - updates - aspirin after heart bypass surgery - Brief Article

"These results are so positive and so definitive," says Robert Bonow, MD, president of the American Heart Association. "It's studies like this that actually change practice."

Bonow refers to a new study that concludes that prescribing aspirin within hours of bypass surgery could prevent 27,000 deaths and 51,000 serious complications worldwide annually. That would save billions of dollars, lower complication rates and shorten hospital stays. Anyone familiar with aspirin's effect on blood will find this news surprising.

Aspirin has been used to treat heart disease because it thins blood and prevents clots. Yet, understandably, many doctors are reluctant to give it soon after or shortly before bypass, fearing it will cause internal bleeding. Such thinking is not only wrong but also probably contributes to some 9,000 deaths each year in the United States alone, according to a study published in the October 23, 2002 issue of the New England Journal of Medicine.

Researchers found that giving heart bypass patients aspirin in doses up to 650 milligrams within 48 hours of surgery cut the death rate by 68 percent during the study period. The chances of stroke decreased by 62 percent; odds of kidney problems fell 60 percent; and risk of a heart attack was nearly cut in half. And this was no small study.

Researcher Dennis Mangano, MD, founder of the San Francisco-based Ischemia Research and Education Foundation, and his team studied 5,065 patients at 70 medical centers in 17 countries.

Surprisingly, the study also found that patients who stopped taking aspirin before surgery were more likely to die than those who kept on taking it. That, too, goes against conventional wisdom.

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