American Heart Association Comment: Lancet (Jan. 24, 19...( Aspirin Reinfarction Study warfarin i...),Health

Aspirin Reinfarction Study, warfarin in a dose of 3 milligrams/day combined with aspirin in a dose of 80 or 160 mg a day did not provide any benefit beyond that achieved with a 160 mg dose of aspirin alone. In the study published in this week's Lancet, T. W., Meade, M.R.C, and other researchers of the Medical Research Council in London found that individuals given a slightly higher dose of warfarin (4 mg a day) and aspirin (75 mg daily) had lower risk of heart attack.

The study included middle-aged men at increased risk for heart attack because they were in the top 20 percent of a "risk score." The score was derived by combining risk factors such as smoking history, body mass index, blood pressure, cholesterol, fibrinogen (a protein that helps form clots) and factor VII coagulation activity (an indication of the viscosity of the blood).

The study found that compared to placebo, warfarin reduced heart attack by 21 percent and heart attack deaths by 39 percent; low-dose aspirin reduced heart attack risk by 20 percent and reduced heart attack deaths by 32 percent. When the drugs were used together, the risk of all heart attacks (both fatal and non fatal) was reduced by 34 percent compared to those taking placebos. Side effects, including hemorrhagic (bleeding) strokes or aneurysm (a leaking blood vessel in the brain) occurred in 15 individuals who had taken warfarin compared to three who had not. Most of the individuals with stroke had high blood pressure. "Physicians must first make sure that before prescribing the combination, patients must have their high blood pressure controlled," says Fuster.

Researchers say treating 1,000 men with the drugs would avoid five heart attacks a year.

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Contact: Carole Bullock
caroleb@amhrt.org
214-706-1279
American Heart Association
22-Jan-1998

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