HealthLawProf Blog

Editor: Katharine Van Tassel
Creighton University School of Law

Wednesday, August 24, 2005

Aspirin Withdrawal

Thanks to Professor Douglas Mossman for this article from medscape.  He points us to a recent study that has been published in the Archives of Neurology that highlights the importance of aspirin therapy for those who are at risk for stroke.  The study shows that withdrawing aspirin significantly increases the risk of stroke.

"Aspirin, or acetylsalicylic acid, is widely used to prevent ischemic vascular disease," write Alexandre Balzano Maulaz, MD, from Centre Hospitalier Universitaire Vaudois in Lausanne, Switzerland, and colleagues. "Clinical and experimental data suggest that a rebound effect occurs four or fewer weeks after interruption of aspirin therapy."

Cases consisted of 309 patients with ischemic stroke (IS) or transient ischemic attack (TIA) undergoing long-term aspirin treatment before their index event, and 309 control subjects who had not had an IS in the previous six months were matched for age, sex, and antiplatelet therapy. The investigators compared the frequency of aspirin therapy discontinuation during the four weeks before a cerebral ischemic event in patients and during the four weeks before interview in control subjects.

Both groups had a similar frequency of risk factors, except for coronary heart disease (CHD), which was more prevalent in IS or TIA patients (36% vs 18%; P < .001). Thirteen IS or TIA patients and four control subjects had discontinued aspirin. After adjustment in a multivariable model, aspirin interruption yielded an odds ratio for IS or TIA of 3.4 (95% confidence interval, 1.08 - 10.63; P < .005).

"These results highlight the importance of aspirin therapy compliance and give an estimate of the risk associated with the discontinuation of aspirin therapy in patients at risk for IS, particularly those with coronary heart disease," the authors write.


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