Study Finds Aspirin
Aids Bypass Patients
Giving aspirin to heart patients soon after bypass surgery dramatically lowers the risk of death and complications, contradicting long-held worries that the tablets can trigger disastrous bleeding, a major study found.
The surprising results -- from 5,065 patients at 70 medical centers in 17 countries -- should quickly change how doctors handle the 1 million patients worldwide who undergo coronary bypass surgery each year, said researchers at the Ischemia Research and Education Foundation and other experts.
Foundation researchers estimate that administering a 5-cent aspirin within hours of bypass surgery could prevent about 27,000 deaths and 51,000 serious complications annually worldwide. It would also save billions of dollars, given the lower complication rate and shorter hospital stays.
Aspirin has been a mainstay of treating and preventing heart disease for a generation because it thins the blood and prevents clots. Yet many doctors are reluctant to give it soon after or shortly before bypass, fearing it will interfere with clotting and cause life-threatening internal bleeding.
In the study, about 60 percent of the patients received aspirin in doses up to 650 milligrams. Those getting aspirin within 48 hours of bypass surgery were only one-third as likely to die in the hospital as the others.
The aspirin group also was only half as likely to suffer a heart attack or stroke while still in the hospital, only one-fourth as likely to suffer kidney failure and about one-third as likely to have bowel damage from blood clots.
The study, conducted from 1996 through 2001, was reported in today's New England Journal of Medicine.
Survey Raises Concerns
About Drug Research
The drug companies that pay for major testing of most new medicines give the participating university researchers little or no say in how the studies are designed and how the findings are handled, a survey found.
The survey of 108 medical schools, published in today's New England Journal of Medicine, is the latest sign of growing concern about conflicts of interest between those doing scientific research and the pharmaceutical companies sponsoring it.
While federal agencies sponsor much early research, large-scale studies of drugs' safety and effectiveness are usually paid for by the manufacturers. Typically, the companies hire medical school faculty members to carry out the studies.
But some scientists worry their lack of control could threaten the integrity of research and the safety of the volunteers participating. Among other things, pharmaceutical companies have sponsored research that found a drug didn't work or was dangerous, then suppressed the results.
Concerned about the problem, the International Committee of Medical Journal Editors in 2001 published guidelines for research contracts between medical schools and the pharmaceutical industry.
Last winter, researchers at Duke University Medical Center and Duke's law school interviewed officials at U.S. medical schools and reviewed some of their research contracts to determine how many complied with the new guidelines. Only a minority did.
Jeff Trewhitt, a spokesman for Pharmaceutical Research and Manufacturers of America, PhRMA, said its member companies three weeks ago started implementing new principles for operating and reporting on clinical trials that "reaffirm our commitment to the safety of research participants and a timely communication of research results."
-- Compiled from reports by the Associated Press