 |
|
|
|
|
|
 |
|
Highlights from the European Aspirin Symposium on Aspirin
| |
It is amazing to think that we are approaching the 110th anniversary of the discovery of aspirin, and yet this wonder drug still continues to astonish healthcare professionals worldwide. When such an inexpensive drug can continue to find new avenues in all fields of medicine, and the mechanism of action is still unfolding – it is not surprising that experts will continue to meet to digest the newest findings.
This year’s European Aspirin Symposium (EAS), which was held mid October in Berlin, Germany, provided such an opportunity for physicians from across Europe to consider the latest aspirin news. Some key highlights from the EAS are presented here.
The cardiovascular disease (CVD) and stroke time-bomb
Atherothrombosis plays a key role in vascular events, and yet the REACH registry, a database of more than 60 thousand patients, tells us that at least a quarter of high-risk patients in the USA and Europe are not using antithrombotic therapy” was the key message from Professor Gaspoz (EAS faculty; Switzerland).
As death from CVD will rise to 24.2 million by 2030 and cerebrovascular disease mortality will remain the second leading cause of death in 2030 – we must wonder how many of these lives can be saved by greater attention to risk prevention strategies with agents such as aspirin. The Partnership for Prevention® (2007) estimates that 45,000 lives will be saved by appropriate aspirin in the USA alone! More from the Partnership for Prevention® can be found via this link: http://www.prevent.org/content/view/129/72/
Greater attention should also be paid to CVD prevention strategies in the Ukraine and Russia, which are associated with the highest death rates. Death from coronary heart disease (CHD) has also increased in Romania, Belarus, Kazakhstan and Croatia, with 3.8 million men and 3.4 million women dying from CHD alone each year.
Aspirin: antithrombotic and beyond
“The anti-platelet-dependent properties of aspirin make it an ideal antithrombotic in a wide range of patients, but more recent studies also show that aspirin has platelet-independent effects, which may be linked to a number of additional clinical benefits, and these have yet to be fully explored” added Professor Hohlfeld (EAS faculty; Germany).
Given the safety issues that limit the long-term use of some coxibs – it is possible that aspirin could find greater utilisation in areas such as arthritis. The role of aspirin in cancer (a high-risk area for thrombotic events) is already winning over any sceptics
Variable drug response: a feature of all drug
‘Aspirin resistance’ should be clearly reworded – was a key message driven by new data presented at this EAS.
Blood pressure response rates can vary according to whether measurements are taken in the clinic, at home or via ambulatory monitoring – aspirin response can also be subject to variations depending on which day the response is measured. In addition, aspirin response relies on small differences in serum TXB2 levels taken by various methods, which are subject to variability added Professor Patrono (EAS faculty; Italy).
Furthermore, emerging drug-drug interaction trials show that some non-steroidal anti-inflammatory drugs (NSAIDS) can blunt aspirin’s efficacy – it is hoped that these new data will enhance current guideline recommendations on combination therapies. Could clearer recommendations and longer-term monitoring also help to alleviate the worry of variable response with aspirin?
Read the new 2008 ACCF/ACG/ACC consensus on reducing gastrointestinal risks with anti-platelets plus NSAIDs here:
http://www.americanheart.org/presenter.jhtml?identifier=3004570
Aspirin recommendations: agreement or disagreement
Based on the key aspirin primary prevention trials – the American Medical Association recommend greater physician and patient education on the benefits of aspirin. Professor Bueno (EAS faculty; Spain) also added that a number of physician-, patient- and system-related barriers need to be overcome in order to improve aspirin under-utilisation, particularly in the treatment of heart disease. Russia has the lowest utilisation of aspirin in stroke, and interestingly, the delegates from that country also remarked that Russia has higher stroke rates than Japan, which is universally recognised as having a very high incidence of stroke.
Professor Ruilope (EAS faculty; Spain) commented on the fact that aspirin can be used anywhere along the cardio-renal continuum. Utilising aspirin in patients with symptomatic end-stage disease can still be associated with benefits (recommended reading on this subject: Califf et al Am J Cardiol 2002;89:653-661).
Disagreement between the guidelines on the risk threshold at which aspirin should be prescribed could be a major limiting factor, and one that needs to be addressed was the concluding message from Professor Brotons (EAS faculty; Spain).
| |
|
|
|
|
|
|
|
|
 |
|
 |
"After five years the external data monitoring board asked that we terminate the study because of a striking, very extreme benefit of aspirin. Aspirin® reduced the risk of a first heart attack by 44 percent, and this was quite an earthshaking finding at that time."
|
|
 |
|
|
Aspirin Cardio® Screensaver
Out now: The new Aspirin Cardio® Screensaver.
Download here...
|
|
 |
|
|
Aspirin Cardio® Trailer
Click here to download the Aspirin Cardio® Trailer "Did you know..."
|
|
|
|
|
|
|
|
|
