Family Physicians advised to promote the use of Low Dose Aspirin Therapy to reduce morbidity and mortality


Prevention and Treatment of CAD, ACS

Family Physicians advised to promote the
use of Low Dose Aspirin Therapy to reduce
morbidity and mortality

Aspirin remains the most economically priced
safe and effective antiplatelet agent

LAHORE: Pakistan Aspirin Foundation in collaboration with Pakistan Association of Family Physicians organized a special session on Aspirin during the recently concluded FAMILYCON 2014 at Lahore. This session was chaired by Prof.Bilal Zakariya Khan, Chief Executive of Punjab Institute of Cardiology. The speakers included Prof. Javed Akram President of Pakistan Aspirin Foundation and Vice Chancellor of Benazir Bhutto University (PIMS) Islamabad and Prof. Akbar Chaudhry Principal of Azra Naheed Medical College Lahore besides Mr.Shaukat Ali Jawaid General Secretary of Pakistan Aspirin Foundation.
Prof. Javed Akram in his presentation highlighted the mode of action of Aspirin and how it inhibits the aggregation of platelets. He also referred to various studies highlighting the safety and efficacy of Aspirin in CAD and various other medical disorders.
Prof. Akbar Chaudhry another eminent physician who is also former President of Pakistan Aspirin Foundation highlighted the use of Aspirin in its well established indications wherein it has proved that it significantly reduces morbidity and mortality. Even a single tablet of 325mg of Aspirin, taken immediately after myocardial infarction can be life saving and its regular use reduce the chances of re-infarction. Studies Prof. Akbar Chaudhry said have shown that the burden of cardiovascular diseases is going to increase further in the coming years and most of this burden will be in developing low resource countries. Since curative services are extremely expensive, prevention remains the only viable option for these countries.
He then referred to various studies which showed that regular use of Aspirin not only prevents heart attacks but is also quite useful in Acute Coronary Syndromes. Coronary Artery Disease has emerged as an epidemic in Pakistan. Modifiable risk factors include control of hypertension, diabetes mellitus, Dyslipidemia, obesity, metabolic syndrome and smoking and this should be supplemented with regular use of low dose Aspirin therapy. Talking about benefits of Aspirin, Prof. Akbar Chaudhry said that it reduces risk of first MI by 33%, risk of first stroke by 25%, risk of CVD death by 17%. In Secondary prevention with Aspirin the risk of serious vascular events are reduced by 46% in unstable angina, 33% in stable angina, 23% in peripheral arterial disease and 53% in patients undergoing angioplasty. Previously Aspirin Awareness and Usage study (AAUS) conducted by Pakistan Aspirin Foundation which enrolled over fifteen hundred patients in seventeen CCUs all over Pakistan showed that only 50% of ACS patients were prescribed Aspirin at the time of discharge, only 20.8% of patients were prescribed Aspirin by their family physicians and only 16% of patients took aspirin at home when they suffered from chest pain. Now as a result of CME activities by Pakistan Aspirin Foundation the use of Aspirin has increased but still the Family Physicians, he said, need to promote its use in its well established indications. It is an extremely safe and effective antiplatelet agent which is economically priced. It is useful in hypertension once the blood pressure has been controlled, is recommended in patients undergoing interventional procedures like angioplasty and stenting, after CABG, in Type-2 diabetics, pulmonary embolism, TIAs and Stroke while its new and emerging indications include colorectal cancer, gastric ulcer, dementia and renal diseases. In case of contra indication like peptic ulcer, asthma, or allergy to Aspirin, other antiplatelet agents should be used. The combination of Aspirin and Clopidogrel, he said is more effective in reducing morbidity and mortality in CAD. Various studies have also showed its efficacy in primary prevention of CAD, he added.
Mr. Shaukat Ali Jawaid Chief Editor Pulse International speaking on the occasion said that you go to any medical conference, use of Aspirin always figures in presentations and discussion. This is the most widely researched drug and every month thousands of papers are published on the safety and efficacy of Aspirin in various medical disorders. Eminent Scottish Physician Dr. Peter Elwood who first proved in 1974 that Aspirin reduces the chances of death in Acute Myocardial Infarction and also prevents secondary infarction always carries Aspirin tablets in his Jacket saying that he or any of his friend might use it any time. Mr.Shaukat Ali Jawaid urged the family physicians to educate the patients to take one tablet of Aspirin immediately when they feel chest pain. They should also keep Aspirin with them all the time in office, clinic and home. Most often heart attacks occur early in the morning when neither the doctor nor transport is available easily hence if the patients experiencing chest pain take one tablet of Aspirin immediately, it might save their lives. Regular use of Low Dose Aspirin 75-100mg is preferable at night. Enteric coated Aspirin is extremely safe and effective in long term use. However, in case of any contraindication, other antiplatelet agents can be used, he added.
Pakistan Aspirin Foundation, he pointed out has also published an informative booklet on Aspirin in Urdu which gives comprehensive details about indications as well contra indications for Aspirin therapy and its doses in various indications. These guidelines are available on its website He also advised the family physicians to adhere to ethical medical practice and improve the quality of general practice and make sure that their services are affordable for the common man. If they failed to do so, they will be indirectly promoting quackery which is already a great menace.
It was also announced that though Pakistan Aspirin Foundation is extremely grateful to M/s ATCO Laboratories for sponsoring its CME activities for the last many years but keeping up the professional ethics, we do not patronize and support any particular brand of Aspirin. It is up to the physicians to prescribe any Aspirin preparation.
Prof. Bilal Zakariya in his concluding remarks said that there have been some reports of Aspirin resistance. The doctors should prescribe Aspirin which is produced by quality conscious pharmaceutical companies so that there are no dissolution problems.