Aspirin Boosts Survival in Unstable Angina Patients

MUNICH — Aspirin saves lives in patients with unstable angina, according to a chart review.

Patients who were treated with aspirin during their acute care hospitalization for unstable angina and who were prescribed aspirin at hospital discharge had a statistically significant 25% reduced risk of dying over the following 17 years, compared with patients who did not get aspirin while in the hospital or receive a prescription for aspirin at discharge, Dr. Michael E. Farkouth and his associates reported in a poster at the annual congress of the European Society of Cardiology.

The finding “confirms our current practice of routine aspirin use to reduce mortality” in patients with unstable angina, Dr. Farkouth, director of the Mount Sinai Heart Clinical Trials Unit at Mount Sinai Medical School, New York, and his associates wrote in the poster.

The study reviewed the records of all residents of Olmsted County, Minn., who presented at one of the three emergency departments in the county with a first episode of acute chest pain during January 1985-December 1992. The analysis then excluded patients who had chest pain for reasons other than unstable angina, leaving 1,628 patients who had definite unstable angina as the cause of their chest pain and hospitalization. The mean age of the patients was 66 years, and 60% were men.

Their records also showed that 41% received aspirin during hospitalization and were also prescribed aspirin at discharge. Five percent of the patients did not get aspirin while hospitalized but did get a discharge prescription, 12% got aspirin only while hospitalized, and 42% did not get aspirin during hospitalization or at discharge.

During an average follow-up of almost 17 years, 986 of the patients died. In a multivariate analysis that adjusted for age, gender, and other baseline characteristics that affected survival, patients who received aspirin while hospitalized and who were prescribed the drug at discharge had the lowest mortality rate during follow-up.

Partial aspirin use also protected against death. Patients who received it during hospitalization but did not receive a postdischarge prescription had an adjusted, statistically significant 17% reduced risk of death, compared with patients who did not get aspirin. Patients who did not get aspirin in the hospital but did get a postdischarge prescription had an adjusted, statistically significant 23% reduced risk of dying, versus patients who did not get it.