Stopping aspirin and risk of myocardial infarction - what do you do?
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Stopping aspirin and risk of myocardial infarction - what do you do?
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I see that there is a study regarding cessation of aspirin for secondary prevention and risk of myocardial infarction. BMJ 2011; 343:d4094 doi: 10.1136/bmj.d4094 (Published 19 July 2011) For every 100
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Forums » Open clinical » Cardiology » Stopping aspirin and risk of myocardial infarction - what do you do?
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Stopping aspirin and risk of myocardial infarction - what do you do?
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Stopping aspirin and risk of myocardial infarction - what do you do?
posted at 25/7/2011 3:02 PM BST
on bmj.com
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Posts: 873
First: 17/6/2011 Last: 17/5/2013 |
I see that there is a study regarding cessation of aspirin for secondary prevention and risk of myocardial infarction. BMJ 2011; 343:d4094 doi: 10.1136/bmj.d4094 (Published 19 July 2011) For every 1000 patients who discontinued aspirin there were 4 nonfatal MIs. This study has clearly got my patients thinking. I had a phone call from a man with angina this morning who has been asked to stop his aspirin for 2 weeks by my plastic surgical colleague as a resection of a probable squamous cell tumor of the left pinna. I have said that he should stop as the risk of surgical bleeding is felt to be high . Would anyone else have said differently? |
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Re: Stopping aspirin and risk of myocardial infarction - what do you do?
posted at 30/7/2011 9:53 PM BST
on bmj.com
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Posts: 2035
First: 12/3/2010 Last: 19/5/2013 |
The consensus is that, except for special situations, such as neurosurgery or urology where the source of post-op. bleeding may be relatively inaccessible and can cause problems in small volumes, that aspirin should be continued through surgery. Is plastic surgery such a special case? I'm not able to say, as that isn't within my experience. In non-cardiac surgery, twice as many patients who did not take their aspirin had evidence of myocardial damage: http://www.ncbi.nlm.nih.gov/pubmed/20150346 That is far higher than the risk of significant bleeding, leading to transfusion with the use of aspirin.. A general review of antiplatelet treatment in the periopertaive period, with a useful algorithm to guide treatment is at: http://www.ncbi.nlm.nih.gov/pubmed/17650517 John |
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Re: Stopping aspirin and risk of myocardial infarction - what do you do?
posted at 30/7/2011 10:34 PM BST
on bmj.com
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Posts: 873
First: 17/6/2011 Last: 17/5/2013 |
I'm interested in what you say John D as from my perspective as a cadiologist I would rather my patients caried on aspirin as clearly surgery is proinflammatry and pro myocardial infarction! Generally however I go with the view of my surgaical colleague as I think that they are much better qualified to assess the bleeding risk of the proposed procedure in their own hands. However reviewing this data makes me wonder whether I should be more categorical about continuing aspirin at lease. |
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Re: Stopping aspirin and risk of myocardial infarction - what do you do?
posted at 31/7/2011 12:57 PM BST
on bmj.com
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Posts: 2035
First: 12/3/2010 Last: 19/5/2013 |
May I suggest, sadian, that you consult the anaesthetists in your hospital? You may find allies and they will appreciate your support. John |
Forums » Open clinical » Cardiology » Stopping aspirin and risk of myocardial infarction - what do you do?
