Researchers from the University of Auckland’s Faculty of Medical and Health Sciences have developed a tool which could potentially save lives.
The tool – developed with help from Middlemore Hospital staff – allows doctors to identify whether patients taking aspirin are likely to suffer from its side-effects.
Thousands of people take aspirin every year to relieve pain and to reduce the risk of heart disease and stroke. However, the drug’s side-effects include blood-thinning, an action which can cause internal bleeding in patients who use it regularly. This bleeding is potentially fatal to those suffering from some kind of heart disease: in a 2002 to 2015 study conducted by the Ministry of Health, roughly 7% of all participants (who were aged between 30 and 79, and who all suffered from cardiovascular diseases) were killed by aspirin-induced internal bleeding.
Not everyone is at risk of internal bleeding though. The risk varies from patient to patient, making aspirin an adequate remedy for some, but a potentially deadly pill for others. Until now, doctors had no way of accurately assessing an individual patient’s risk. The tool developed by the university’s researchers fixes this problem by providing doctors with bleeding-risk models that they can apply to specific patients. The models take into account the patient’s individual characteristics (which might include their age, smoking habits, diabetes history, ethnicity and more) to determine whether or not aspirin is likely to cause internal bleeding.
The research was published in the Annals of Internal Medicine earlier this year. Lead author Dr Vanessa Selak says there tends to be “a lot of confusion about who should take [aspirin]”. “For people who have already had a heart attack or stroke, the benefit of aspirin in reducing cardiovascular disease generally outweighs its harms in increasing bleeding,” she says, but “guidelines are unclear in people who are at high risk of having their first heart attack or stroke … so it is likely that some people are receiving aspirin when they shouldn’t be and others are not receiving it when they could potentially benefit from it”. She says she is hopeful these models will relieve some of the confusion surrounding aspirin prescription.
Dr Selak says the team’s next step will be to “develop a calculator that integrates the benefits and harms of aspirin for prevention of [cardiovascular disease] to make it easier for clinicians to work out, for a specific patient, whether the benefits of aspirin are likely to outweigh its harms”. It is believed this benefit-harm calculator would be a world-first if created.