Aspirin Discontinuation Quickly Increases Cardiovascular Event Risk

Discontinuation of long-term, low-dose aspirin—whether taken for prevention of first or recurrent cardiovascular events—is associated with a significantly increased risk of cardiovascular events, according to the results of a recent study.

To investigate the effects of aspirin discontinuation in the absence of major surgery or bleeding, researchers performed a cohort study of 601,527 participants in the Swedish prescription register between 2005 and 2009. All participants were aged 40 years or older, were free from cancer, and had an 80% or greater adherence to aspirin during the first observed year of treatment.
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Over a median of 3 years of follow-up, 62,690 cardiovascular events occurred. Higher rates of cardiovascular events were observed in those individuals who discontinued aspirin use, compared with those who continued using aspirin (hazard ratio 1.37). The risk did not appear to diminish over time.

“In long-term users, discontinuation of low-dose aspirin in the absence of major surgery or bleeding was associated with a >30% increased risk of cardiovascular events. Adherence to low-dose aspirin treatment in the absence of major surgery or bleeding is likely an important treatment goal.”

—Michael Potts

Reference:

Sundstrom J, Hedberg J, Thuresson M, et al. Low-dose aspirin discontinuation and risk of cardiovascular events [published online September 25, 2017]. Circulation. https://doi.org/10.1161/CIRCULATIONAHA.117.028321.