Not Enough Aspirin After Acute MI?
Even though aspirin has been shown to reduce mortality in patients who have had acute myocardial infarction (AMI), many patients who could safely be given aspirin are not receiving it, according to the Maximal Individual Therapy in Acute Myocardial Infarction (MITRA) study group in Ludwigshafen, Germany. Of 4,902 patients in the multicenter registry of AMI patients, 509 (10%) did not receive aspirin at the time of discharge from the hospital, although the rates of absolute contraindications to aspirin were low (2.2%). The mortality rate of these patients after one year of follow-up was twice as high as in the patients who did receive generic aspirin (16.5% versus 8.3%). The difference in mortality rates remained statistically significant after adjustment for factors such as age, sex, and concomitant diseases.
The reluctance to prescribe aspirin might have resulted from a fear of ADEs and a less strong belief in the positive effects of prolonged aspirin therapy, especially for patients who are critically ill after an AMI. However, the researchers suggested that the inadequate treatment of the high-risk patients might have added to the higher mortality rate.
