Aspirin at Discharge
According to the US Preventive Services Task Force, aspirin is recommended to decrease the incidence (frequency of new cases) of heart disease in adults who have risk factors for heart disease. Individuals who are at increased risk for bleeding, however, may not be candidates for aspirin therapy because aspirin thins the blood, further increasing the risk of bleeding.
The American College of Cardiology/American Heart Association Task Force on Practice Guidelines found Class I evidence (highest level of scientific support) for taking aspirin indefinitely after a heart attack (Circulation, September, 2000: 102 (10); 1193-1209).
Evidence for this guideline has existed since the mid to late 1990s and has been further supported by subsequent research. “Long-term aspirin therapy confers conclusive net benefits on risk of subsequent MI [myocardial infarction], stroke, and vascular death among patients with a wide range of prior manifestations of cardiovascular disease” (Circulation, October 21, 1997: 96(8); 2751-2753).
Unless otherwise contraindicated, the protocol at UAMS Medical Center includes prescribing daily aspirin for heart attack survivors after hospital discharge.
The most recent report (4th qtr., 2013) shows 100% of UAMS heart attack survivors were prescribed daily aspirin at discharge, compared to the national average of 99% and the average for University Healthsystem Constorium hospitals of 99%.