Taking aspirin to ward off heart
attack 'risks stomach bleeding'
The "worried well" should not take aspirin to ward off a heart attack as its
preventative benefits are cancelled out by an increase in the risk of stomach bleeding,
researchers have warned
Lees
verder
Aspirin and similar drugs may be
associated with brain microbleeds in older adults
Individuals who take aspirin or other medications that prevent blood clotting by
inhibiting the accumulation of platelets appear more likely to have tiny, asymptomatic
areas of bleeding in the brain, according to a report posted online today that will appear
in the June print issue of Archives of Neurology, one of the JAMA/Archives journals.
Cerebral microbleeds—small deposits of the iron-storing protein hemosiderin in the
brain—may be a sign of cerebral small-vessel disease, according to background
information in the article. This condition, common among older adults, occurs when the
walls of blood vessels in the brain become weakened. When microbleeds occur in certain
brain areas, they may indicate a type of small vessel disease known as cerebral amyloid
angiopathy, in which the accumulation of amyloid (a protein often related to Alzheimer's
disease) causes degeneration of smooth muscle cells and increases the susceptibility of
blood vessels to ruptures and hemorrhages. Meike W. Vernooij, M.D., and colleagues at
Erasmus MC University Medical Center, Rotterdam, the Netherlands, investigated the
relationship between cerebral microbleeds and the use of anti-clotting medications in
1,062 individuals without dementia involved in the Rotterdam Scan Study. Participants
(average age 69.6) underwent magnetic resonance imaging examinations in 2005 and 2006.
Pharmacy records were used to assess whether any of the individuals took anti-clotting
drugs. These included aspirin and carbasalate calcium—called platelet aggregation
inhibitors because they prevent the accumulation of platelets that form blood clots. In
the years before MRI, 363 (34.2 percent) of the participants had used any anti-clotting
drugs, including 245 (23.1 percent) who took platelet aggregation inhibitors (67 taking
aspirin and 141 taking carbasalate calcium). Compared with patients who did not use
anti-clotting drugs, those who took aspirin or carbasalate calcium were more likely to
have cerebral microbleeds visible on MRI. This association was particularly strong among
individuals taking these drugs at higher doses, typically used to treat or prevent heart
disease. Microbleeds in the frontal lobe were more common among aspirin users than
carbasalate calcium users. There was no association between other types of anti-clotting
drugs and cerebral microbleeds. "There is currently major interest in bleeding risks
with the use of antithrombotic or thrombolytic treatment in persons who have microbleeds
that are apparent on MRI because this may affect treatment in patients with cardiovascular
or cerebrovascular disease," the authors write. "The cross-sectional design of
our analyses prohibited an investigation of whether persons with cerebral microbleeds are
at increased risk for symptomatic hemorrhage [excessive bleeding] when using platelet
aggregation inhibitors." The beneficial effects of anti-clotting drugs for
individuals at risk for heart attack and stroke typically outweigh any risks of bleeding,
they note. "Nevertheless, it may be that in selected persons (e.g., those with signs
of cerebral amyloid angiopathy), this risk-benefit ratio may differ for certain drugs
(e.g., aspirin), thus influencing treatment decision," they conclude.
Lees verder
Ibuprofen destroys aspirin's
positive effect on stroke risk
Stroke patients who use ibuprofen for arthritis pain or other conditions while taking
aspirin to reduce the risk of a second stroke undermine aspirin's ability to act as an
anti-platelet agent, researchers at the University at Buffalo have shown.
Lees verder
|
|
|
|