A study of more than 250 people showed that most of those who
took low-dose or coated aspirin in fact saw no reduced blood
clotting, the researchers told a meeting of the American Stroke
Association in Phoenix.
Full-sized, uncoated aspirin seemed more effective, according to
a measurement of the blood's stickiness called platelet function,
said Dr. Mark Alberts, director of the Stroke Program at
Northwestern Memorial Hospital in Chicago.
"More than 50% of patients who got coated or low dose aspirin
seemed to have normal platelet function," Alberts said in a
telephone interview. "This is remarkable."
He said his study would help explain why aspirin does not seem to
work for many people. "About half the patients who have a heart
attack or stroke are taking aspirin at the time they have a heart
attack or stroke," he said.
Several studies have shown that aspirin can reduce blood
clotting, lowering the risk of heart attack and stroke. Stroke is
the third leading cause of death in the United States, affecting
750,000 people a year and killing 165,000.
But aspirin can be dangerous. It and related drugs are blamed for
thousands of deaths every year, so doctors want patients to take the
lowest-possible dose that is effective.
Alberts and colleagues tested 126 patients prescribed aspirin
after having strokes or clogged arteries to the brain.
LOW-DOSE ASPIRIN WORK IN FEWER THAN HALF
The patients were taking various doses and formulations of
aspirin. Alberts found that 56% of those taking 81 milligram "baby"
aspirin had no changes in blood clotting.
But 72% of patients taking 325 mg aspirin pills had measurable
effects.
He found 65% of patients taking coated aspirin--no matter what
the strength--had no reduced clotting, while 75% of patients taking
uncoated aspirin did have reduced clotting.
Alberts stressed that no one should be taking aspirin to prevent
heart disease or stroke without first visiting a doctor. But he said
his study suggests that doctors may want to take the time to check
to see whether aspirin is working in a patient, perhaps using the
platelet test.
The findings have implications for more than patients.
Bayer this week asked the US Food and Drug Administration (news
- web
sites) to allow it to market aspirin to prevent a first heart
attack or stroke, and it has launched a specially packaged 81 mg
coated aspirin product.
In 2002 Bayer sued rival Johnson & Johnson over Johnson's
advertising for its St. Joseph brand of aspirin, which comes in a
"baby" dose. Bayer argued that larger doses of aspirin were more
effective than the lower doses.
Dr. Allen Heller, vice president and head of global research and
development for Bayer, said he would have to study the findings
further but also stressed that no one take aspirin for preventing
heart disease without a doctor's advice. But he said Bayer had
little guidance for doctors.
"We don't tell doctors what dose to prescribe," he said.
Aspirin is not approved for children or babies because it can
cause a fatal brain condition called Reye syndrome.