Taking aspirin to prevent a heart attack

If you’re one of the millions and millions of people who has not yet had a heart attack but you’re taking Aspirin anyway in the hopes it might prevent one, you should be very interested in a study called COMPASS which was presented at the Congress of the European Society of Cardiology (ESC) in Barcelona, Spain (and which will be in the New England Journal of Medicine.

In COMPASS, which by the very important way, is spear-headed by Canadians (woo hoo), the researchers conclude that in people who already had heart disease, a combination of a drug called rivaroxaban taken twice daily plus 100 mg of aspirin (which is slightly more aspirin than the 81 mg that is present in the usual Canadian dose of “baby aspirin”) was much better at preventing heart attacks and strokes than aspirin alone.

The key caveats?

  1. The people in this study had known – not suspected – heart disease; they were not, in theory at least, the healthy well
  2. That combination of drugs does increase the chance of a major gastrointestinal bleed, although in this study, which was terminated early, this drug combo did not increase the risk of other key bleeds such as strokes

So what should you do?

I am still one of the holdouts who believes that if you haven’t had a major cardiovascular event, you shouldn’t take aspirin, so this study doesn’t change my mind.

But that’s something for every individual to decide for themselves.