Despite evidence that aspirin can work as an effective prevention tool in patients with coronary artery disease, aspirin use in such patients is low, according to a study from the Massachusetts General Hospital (MGH).
The report, appearing in the March 14 issue of Circulation: Journal of the American Heart Association, looked at physician-reported rates of aspirin use in patients with coronary artery disease; in 1996, about one quarter reported taking aspirin.
"With all of the investment this country makes developing new medications to treat disease, it is very important to utilize the medications we already have effectively," said Randall Stafford, MD, PhD, of the MGH Institute for Health Policy and General Medicine Division, the study's author.
Coronary artery disease - also commonly referred to as coronary heart disease - is the single largest killer of both men and women in the U.S. An estimated 1.1 million Americans will suffer heart attacks this year, and more than 40 percent of them will die. In this disease, blood vessels in the heart become narrowed causing such problems as angina, heart attacks and sudden death. Among patients known to have coronary artery disease, the use of aspirin cuts the risk of future problems by one third by interfering with the formation of blood clots.
Stafford and his team used data from the National Ambulatory Medical Care Survey from 1980 to 1996. In this annual survey, conducted by the National Center for Health Statistics, during a randomly selected week physicians complete a form after outpatient visits, answering questions about patients' diagnoses and the treatments provided.
Analysis of 10,942 office visits of patients with coronary artery disease found that reported aspirin use had increased from 5 percent of patients in 1980 to 26 percent in 1996. The study also showed that aspirin use was less likely to be reported in patients over the age of 80 and that more men than women reportedly took aspirin. Cardiologists were slightly more likely than primary care physicians to recommend aspirin to patients.
Although Stafford acknowledges that physicians and their patients may fail to report aspirin use and that some patients should not take aspirin, he adds "even if aspirin use were double what we report, this would still represent suboptimal use of this life-saving medication. A substantial number of patients are at higher than necessary risk of developing future heart problems because they are not taking aspirin."
This study was supported by the National Heart, Lung, and Blood Institute.