 The role of aspirin in a heart attack
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Its role before, during and after a heart attack
The main ingredient of aspirin is a modified version of a substance called salicylic acid. This salicylic acid is found naturally in many plants and trees. The fever reducing and pain relieving properties of the bark of the willow tree, which contains salicylic acid, was known to the ancient Greeks and the Chinese. When the substance was synthesised in 1897 by scientists of the Bayer pharmaceutical company of Germany, its release was blocked by the chief scientist, who argued that the medicine might harm the heart. When Germany was defeated in World War-II, America got the aspirin patent transferred, as part of the victory prize in the ‘Treaty of Versailles’. Today, there is no greater friend for a person suffering a heart attack than aspirin and a quick ride to the nearest hospital.
Aspirin is cheap, available everywhere and without need for a prescription. But, this does not mean that everybody gets to take an aspirin without consulting a doctor. Although aspirin has tremendous impact in heart attacks, it can also hurt the stomach lining and cause ulcers and bleeding problems. Hence, one has to discuss with the doctor if taking aspirin is the right step.
Now let us assume that one has discussed the benefit of aspirin with the doctor. What are the favourable points that one is likely to hear?
During a heart attack:
When somebody suffers from symptoms of a heart attack, it is important to give them Aspirin in doses of 162 or 325 mg and it is best if the patient chews the tablet. Aspirin therapy during the initial stages of a heart attack will reduce the risk of death by 25 per cent. There is no other single treatment action for heart attack that produces such a dramatic reduction in death. In the immediate aftermath (within 30 days) of a heart attack, some patients may have a recurrent heart attack. Aspirin reduces that risk by almost 50 per cent.
After a heart attack:
In patients who have already suffered a heart attack, the long-term use of aspirin in doses ranging from 81 mg to 325 mg everyday has been shown to reduce the long-term risk of a repeat heart attack by 25 per cent. No big difference in the beneficial effect of aspirin between the different dosages mentioned above, have been definitively shown by research. Hence, if your doctor does not find a reason to not place you on aspirin, every person who has suffered from a heart attack should be on a daily regimen of this wonder drug.
Before a heart attack:
The various research studies done to determine the beneficial effect of reducing the risk of a first heart attack has led to controversial results. Let us say, that at this point in time, the decision to take an aspirin by those who have not had a heart attack is best left to be decided between the patient and his doctor.
Aspirin has also been shown to reduce the risk of stroke that leads to paralysis of the arms and legs and some research studies have also demonstrated some cancer protective effects, among other benefits. Nevertheless, aspirin is not all angelic and it does have its own negative side-effects.
Hence, let us all ensure that we take our doctor's advice before popping that aspirin into our mouth.
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Dr G Balachander
Cardiologist
Illinois, USA
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