The actual paper is here.
Older people who take aspirin to prevent a recurrent cardiovascular event should take a proton-pump inhibitor to lower their risk of serious bleeding complications, say the authors of a new study published in the Lancet.
After a transient ischemic attack, ischemic stroke, or myocardial infarction, aspirin is commonly taken to prevent a recurrent event. Although aspirin is taken by 40% to 60% of people over 75, the studies demonstrating the safety of aspirin were performed in trials with younger participants.
Researchers in Oxford, led by Peter Rothwell, MD, PhD, followed 3,166 people taking antiplatelet therapy, predominantly aspirin, following a CV event. About half the patients were over the age of 75. The risk of major bleeding, including fatal bleeds and major upper GI bleeds, increased dramatically with age. Further, a higher proportion of GI bleeding events were disabling or fatal in older patients, and these events outnumbered disabling or fatal intracerebral hemorrhage.
Alcohol septal ablation (ASA) was safe and effective for younger obstructive hypertrophic cardiomyopathy (HCM) patients in a study with long-term data, leading investigators to call for a broadened indication for the procedure.ASA patients ages 50 years and younger had lower periprocedural mortality (0.3% versus 20%, P=0.03) and pacemaker implantation rates (8% versus 16%, P<0.001) than those of their peers over 65, reported Max Liebregts, MD, of St. Antonius Hospital in the Netherlands, and colleagues.
The younger patients shared the same 1% annual odds of adverse arrhythmic events with older groups (P=0.90). However, functional recovery was more likely in the younger group. During 5.4 years' follow-up, 95% of young patients studied reached New York Heart Association functional class I or II, compared with 81% among those 65-years-and-older (P<0.001), according to the study published in the June 12 issue of JACC: Cardiovascular Interventions.