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Inappropriate aspirin use for CVD prevention high and varies by practice
Key clinical point: More than 10% of heart patients are inappropriately prescribed aspirin for CVD prevention. Major finding: 11.6% of patients...
“The discussion you have to have with your patient is which do you fear more: an MI or bleeding? You have to tell your patient that not all heart attacks or bleeds are the same. Maybe one-quarter or one-third of those bleeds are going to be intracerebral. And for me, an intracerebral bleed is a lot worse than a nonfatal heart attack, at least most of the time,” Dr. Tanaka continued.
In his own practice he finds himself recommending statins for primary prevention many times more frequently than aspirin.
“The people who qualify for aspirin will definitely quality for a statin, and statins are safer medicines with a proven cardiovascular mortality benefit. Statins have their own problems, but they don’t include GI and intracranial bleeding,” he said.
He emphasized that in contrast to primary prevention, aspirin for secondary cardiovascular prevention is unequivocally beneficial, with multiple studies showing a benefit-to-risk ratio of about 10-to-1.
Dr. Tanaka reported having no financial conflicts regarding his presentation.