Dr. Centor and Dr. Zoe McQuilten discuss the risk of anemia in older patients taking aspirin. They explore a study revealing that low-dose aspirin did not prolong disability-free survival and increased the risk of major bleeding. The podcast examines iron deficiency in older individuals, the impact of aspirin on anemia and iron levels, and the difference between aspirin dosages. A study highlights the increased risk of major bleeding, iron deficiency, and significant anemia with low-dose aspirin. Caution is advised in using aspirin in cardiovascular disease patients and monitoring for iron deficiency is emphasized.
Aspirin use for primary prevention in older patients increases the risk of developing anemia over five years and leads to a steeper decline in hemoglobin levels compared to placebo.
Lodos Aspirin is associated with a higher proportion of iron deficiency in elderly individuals, as indicated by lower ferritin levels, highlighting the potential impact on iron levels.
Deep dives
Impact of Lodos Aspirin on Iron Deficiency and Anemia in Elderly: Study Analysis
A study analyzed the impact of Lodos Aspirin on iron deficiency and anemia in elderly individuals. The study was part of the Aspirin in Reducing Events in the Elderly trial, which evaluated the effects of aspirin in healthy older individuals for primary prevention. The trial showed that while aspirin did not prolong disability-free survival, it increased the risk of major bleeding. As part of the trial, participants had regular hemoglobin measurements, allowing researchers to assess the development of anemia. The study found that the risk of developing anemia over five years was higher in the aspirin group compared to the placebo group. Additionally, participants receiving aspirin had a steeper decline in hemoglobin levels compared to those on placebo.
Association Between Lodos Aspirin and Iron Deficiency
The study also investigated the association between Lodos Aspirin and iron deficiency. Participants in the aspirin group had a higher proportion of iron deficiency compared to the placebo group. Using a ferritin cutoff of 45 milligrams per liter, 13% of the aspirin group met the definition of iron deficiency, compared to 9.8% in the placebo group. Similarly, using a cutoff of 100 milligrams per liter, 39% of the aspirin group had iron deficiency, compared to 31% in the placebo group. The study also observed a greater decrease in ferritin levels in participants allocated to aspirin, suggesting a potential impact on iron levels.
Implications for Aspirin Use in Primary Prevention
The findings of the study have implications for aspirin use in primary prevention. While the study focused on the risks of aspirin in the context of primary prevention, it does not discount potential benefits of aspirin for secondary prevention. However, clinicians should be cautious about the potential harm of aspirin, including the increased risk of anemia and iron deficiency. Monitoring iron and hemoglobin levels more closely in patients taking aspirin for secondary prevention is recommended to ensure early detection and appropriate management of any adverse effects.