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Coronary syndromes following aspirin withdrawal: a special risk for late stent thrombosis

Emile Ferrari1, Mustapha Benhamou, Pierre Cerboni

  • 1Cardiology Department, Pasteur Hospital, 30 Avenue de la voie Romaine, Nice, Alpes Maritimes 06200, France. ferrari.e@chu-nice.fr

Journal of the American College of Cardiology
|February 1, 2005
PubMed

Insights

Stopping aspirin therapy in patients with coronary disease increases the risk of recurrent heart events, including late stent thrombosis. This withdrawal is a significant factor in coronary recurrences.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Pharmacology

Background:

  • Aspirin is crucial for managing coronary artery disease.
  • Concerns about bleeding and compliance often lead to aspirin discontinuation.
  • The impact of aspirin withdrawal on coronary patients is not well understood.

Purpose of the Study:

  • To investigate the occurrence and impact of aspirin withdrawal in patients experiencing coronary events.
  • To determine if aspirin cessation is linked to relapses in coronary artery disease patients.

Main Methods:

  • A cohort of 1,236 patients hospitalized for acute coronary syndrome (ACS) between 1999 and 2002 were surveyed.
  • The study assessed the interruption of aspirin intake among these patients.
  • Data on subsequent coronary events and stent thrombosis were collected.

Main Results:

  • Aspirin withdrawal preceded 13.3% of recurrent coronary events, with 4.1% of all events occurring within one month of cessation.
  • Patients who stopped aspirin had a higher incidence of ST-segment elevation ACS (39% vs. 18%).
  • Late stent thrombosis occurred in 20% of cases, with a mean delay of 10 days between withdrawal and event.

Conclusions:

  • Aspirin withdrawal poses a significant risk for new coronary events in patients with coronary disease.
  • Late stent thrombosis is a notable complication following aspirin cessation.
  • Further prospective studies are needed to precisely quantify coronary recurrences after aspirin withdrawal.
Abstract

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