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Aspirin use in chronic heart failure: what should we recommend to the practitioner?

Barry M Massie1

  • 1Department of Medicine and Cardiovascular Research Institute, University of California, San Francisco, California, USA. barry.massie@med.va.gov

Journal of the American College of Cardiology
|September 20, 2005
PubMed

Insights

Aspirin use in chronic heart failure (CHF) is controversial. Recent studies show aspirin increases hospitalizations for worsening heart failure, suggesting it should be avoided in most CHF patients.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Controversy exists regarding aspirin use in chronic heart failure (CHF).
  • Aspirin is known to prevent vascular events, but its benefit in CHF patients is debated.
  • Potential adverse effects include prostaglandin inhibition, impacting hemodynamics and renal function.

Purpose of the Study:

  • To evaluate the current evidence on aspirin's role in patients with chronic heart failure.
  • To determine if aspirin provides benefits or risks in the CHF population.

Main Methods:

  • Review of existing literature and analysis of recent prospective randomized studies.
  • Assessment of aspirin's impact on vascular events and heart failure hospitalizations.

Main Results:

  • Two recent studies indicate aspirin is linked to increased hospitalizations for worsening heart failure.
  • Aspirin did not demonstrate an adverse effect on vascular events in these studies.
  • Potential benefits may exist for patients with recent infarction or multiple vascular risk factors.

Conclusions:

  • Routine aspirin use is not recommended for all chronic heart failure patients.
  • Aspirin should be avoided in patients with refractory CHF.
  • Consideration for aspirin may be appropriate in specific subgroups, such as those with recent myocardial infarction or high vascular risk.

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