Health. Warning: aspirin can be dangerous in certain situations

Chronic coronary syndrome is the most common chronic cardiovascular disease and the leading cause of death in developed countries.

Also called angina pectoris, or angina pectoris, it requires regular medical follow-up and a good lifestyle.

In France, 1.5 million people are affected, nearly half of whom are over 75 years old.

These patients usually receive preventive treatment with an antiplatelet drug, most often low-dose aspirin, prescribed for life. This treatment reduces the risk of blood clots and protects against the occurrence of another heart attack.

However, many of these patients also receive a second treatment, an anticoagulant to thin the blood, particularly in cases of heart rhythm disorder (atrial fibrillation).

The question doctors were asking was simple but crucial: should aspirin be continued in addition to the anticoagulant, or is the anticoagulant alone sufficient?

A study including 51 cardiology centers, and resulting from the merger of three hospital projects from the university hospitals of Brest, Lille and Nîmes, provides an unequivocal answer: aspirin does not provide any additional protection against cardiac recurrences when combined with an anticoagulant.

This work, carried out on 872 patients at high risk of recurrence, was supposed to last two years… But it had to be stopped prematurely: a significant increase in bleeding was observed in patients on aspirin.

"These results are clear and could modify future international cardiology recommendations," the authors indicate, suggesting that, for patients with chronic coronary artery disease, including those at high risk, aspirin should not be prescribed long-term in addition to anticoagulant therapy when the latter is necessary, particularly for atrial fibrillation."

Note: Of course, if you are a coronary patient on anticoagulants and aspirin, it is crucial never to modify or interrupt your treatment without medical advice.