*EMBARGOED All research presented at the 2022 ACG Annual Scientific Meeting and Postgraduate Course is strictly embargoed until Sunday, October 23, 2022, at 12:00 pm EDT.
Poster D0301 – Deprescription of Aspirin for Primary Cardiovascular Prophylaxis Is Rarely Performed at Discharge in Hospitalized Patients With Gastrointestinal Bleeding
Tuesday, October 25, 2022 | 10:00 AM – 12:00 PM ET | Location: Crown Ballroom
Author Insight from Darrick K. Li, MD, PhD, Yale University School of Medicine
What’s new here and important for clinicians?
The use of low-dose aspirin for primary cardiovascular prevention is very common and is associated with an increased risk of gastrointestinal bleeding, though the absolute increase in risk is small. However, aspirin in this setting is contraindicated in patients with a history of gastrointestinal bleeding. Aspirin deprescription patterns at discharge in patients hospitalized with gastrointestinal bleeding are unknown. We found:
- Deprescription of primary prevention aspirin in patients hospitalized with gastrointestinal bleeding is rare (9% in our population).
- Deprescription of aspirin was not associated with increased incidence of major adverse cardiac events (myocardial infarction, stroke, cardiovascular death) and was associated with a numerically decreased incidence of a second hospitalized for gastrointestinal bleeding compared to continuing aspirin at discharge.
- Documentation for the indication for continued aspirin treatment was exceedingly rare (5% in our population).Our findings highlight an important target for hospital-based quality improvement initiatives in hospitalized patients and emphasizes the safety for deprescription of primary prevention aspirin in this population. To our knowledge, our study is the first to evaluate primary prevention aspirin deprescription patterns in hospitalized patients with gastrointestinal bleeding.
What do patients need to know?
- Aspirin for primary prevention is indicated for an increasingly selective population of individuals based on recent guideline changes.
- Patients with a history of gastrointestinal bleeding are not recommended to be on primary prevention aspirin and should be taken off their aspirin if they are taking it.
- In our study, deprescription of primary prevention aspirin in patients who were hospitalized with gastrointestinal bleeding was safe and was not associated with an increased risk of heart attack, stroke, or death related to cardiovascular causes compared to those who were continued on their aspirin at discharge.
- Patients who are on primary prevention aspirin and are hospitalized with gastrointestinal bleeding should discuss discontinuing their aspirin with their health care providers.
Read the Abstract
Darrick K. Li, MD, PhD, Yale University School of Medicine
darrick.li [at] yale.edu
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