Aspirin as effective as warfarin for heart patients

Aspirin works equally well as the more expensive drug warfarin for patients with heart failure, according to a study published today in the New England Journal of Medicine. Moreover, aspirin was found to be safer given that fewer patients taking it experienced bleeds caused by their blood thinning too much.

Around 900,000 people in the UK are affected by heart failure and it is the leading cause of death. Heart failure happens when the heart is having trouble pumping enough blood around the body and usually occurs because the heart muscle has become too weak or stiff to work properly.

US researchers from Columbia University, New York, coordinated an international study involving 11 countries. A group of 2,305 patients with normal heart rhythm were given either aspirin or warfarin and their progress was followed for up to six years. The researchers found there was no difference in the combined risk of death, stroke and major bleeding between patients taking the blood-thinner warfarin and those taking aspirin.

Besides acting as a painkiller aspirin also acts as an anti-inflammatory agent. The pill thins the blood and a low daily dose of 75mg has been found to reduce the risk of clots forming in the blood. Research suggests the benefits of taking a daily aspirin outweigh the small risk of side-effects in patients with heart disease, although a doctor should always be consulted.

A series of studies involving 200,000 patients found the pill also cut the risk of dying of cancer by 37 per cent if taken for five years. However, haemophiliacs and those with ulcers should not take it. Children under 16 should not take it as it has been linked to an often fatal condition called Reye’s syndrome.

Research leader Dr Shunichi Homma, said “Since the overall risks and benefits are similar for aspirin and warfarin, the patient and his or her doctor are free to choose the treatment that best meets their particular medical needs. However, given the convenience and low cost of aspirin, many may go this route.”

Ellen Mason, senior cardiac nurse at charity the British Heart Foundation, said “Warfarin and aspirin each have their own relative benefits and risks. Yet, this research shows that neither has an advantage over the other overall in preventing stroke or death in the long term. This finding should give patients reassurance when discussing their medication with their heart failure specialist, and more freedom to choose the treatment which works best for them. However, this research does not apply to people with an irregular heart rhythm, known as atrial fibrillation. People with this condition will most likely continue to require warfarin to prevent stroke.”

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