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Totality of evidence shows aspirin reduces risk of a first heart attack by one-third


Aspirin conclusively reduces the risk of a first heart attack by 32%, according to a new report by researchers at Mount Sinai Medical Center & Miami Heart Institute. The findings were presented today at the American Heart Association’s Scientific Sessions in Chicago.

Charles H. Hennekens, MD, co-director of Cardiovascular Research, published the first randomized trial of aspirin in primary prevention. Under his direction, Rachel S. Eidelman, MD, a cardiology fellow, performed a detailed meta-analysis of the five randomized trials evaluating aspirin in the primary prevention of a first heart attack. The data conclusively demonstrate that aspirin significantly reduces the risk of a first heart attack by 32% as well as the combined risk of heart attack, stroke and vascular death by 15%.

These findings strongly support the recent guidelines from the American Heart Association (AHA) that aspirin should be recommended for all men and women whose 10-year risks of a first coronary event are 10% or greater. The U.S. Preventive Services Task Force released a similar position earlier this year, urging all physicians to speak about aspirin therapy with patients who have a 6% or greater 10-year risk of a coronary event.

"The individual trials and their meta-analysis strongly support the recent AHA recommendation," noted Dr. Hennekens. "The more widespread and appropriate use of aspirin in primary prevention could avoid more than 160,000 heart attacks and many other vascular events each year."

In 1988, Dr. Hennekens published the landmark Physicians’ Health Study (PHS) findings. The PHS was terminated early due to the emergence of an extreme 44% reduction in risk of a first heart attack among those assigned at random to aspirin. There have been four primary prevention trials published since then, three of which showed similar positive findings for aspirin.

"We found that the current totality of evidence strongly supports our initial findings from the Physicians’ Health Study that aspirin significantly reduces the risk of a first heart attack in apparently healthy individuals," added Dr. Hennekens. "These data, along with the findings that aspirin reduces the risk of death by 23% if given during a heart attack and by 15% in a wide range of people who have survived prior cardiovascular events, demonstrate that more widespread and appropriate use of aspirin in secondary and primary prevention would avoid many premature deaths and heart attacks."

Coronary heart disease is the single leading cause of death in the United States, accounting for more than 500,000 deaths annually. Approximately 80% of deaths from coronary heart disease in people under age 65 occur during the first heart attack.

Mount Sinai & Miami Heart’s Cardiovascular Center of Excellence is committed to being a leader in the prevention, diagnosis and treatment of heart disease. The medical center is the largest cardiac services provider in South Florida, conducting approximately 1,300 open heart procedures and approximately 7,400 diagnostic and therapeutic cardiac catheterizations annually. For a physician referral, please call (305) 674-2273.

Lauren Mazzella | EurekAlert!

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