Patients with heart failure aspirin can kill

Patients with heart failure aspirin can killIn patients with congestive heart failure receiving ACE inhibitors, additional intake of high doses of aspirin can increase the risk of death reported in issue of the Archives of Internal Medicine 14 July. Dr. Maurizio D. Guazzi and his colleagues (University of Milan universitГ degli Studi) analyzed data from 344 patients discharged from hospital with a diagnosis of congestive heart failure (CHF) and taking ACE inhibitors. All patients were older than 70 years and had no contraindications to ACE inhibitors or aspirin. Only ACE inhibitors took 235 people, inhibitors and aspirin in doses up to 160 mg/day to 45 people, inhibitors and aspirin dose of 325 mg/day or more - 64. For all the observation time (a maximum of 10 years, the median 37.6 months) was registered 134 death. Mortality rates, respectively, 36%, 33% and 55%. Thus, with the additional intake of high doses of aspirin survival rate was significantly lower (p=0.009). Low-dose aspirin on mortality was not significantly affected. After correction for the etiology of CHF, age, status, Smoking, diabetes, and other confounding factors, this Association was still statistically significant: the risk ratio of 1.03 (p=0.01). According to Italian researchers, the main reason is that "aspirin inhibits eicosanoid-dependent activity of ACE inhibitors: regulation of vascular tone; prevention of hyponatremia, dysfunction and remodeling of the left ventricle; the reduction of neuro-humoral activation; facilitating gas exchange through the alveolo-capillary membrane, and so on". Cardiosite.ru (with reference to Arch Intern Med 2003;163:1574-9).



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