People who might be having heart attack should get aspirin on the way to the hospital, but about half of patients in the US don't get this potentially life-saving treatment, according to a recent review. National guidelines recommend giving aspirin to heart attack patients as soon as possible, but emergency medical service (EMS) providers sometimes omit this vital step, the authors say in a Reuters Health report.
"We were interested in knowing how often patients that presented with symptoms suggestive of a heart attack were given aspirin by EMS providers," said lead author Dr Katie Tataris, an EMS medical director in Chicago and assistant professor of emergency medicine at the University of Chicago. Tataris and her colleagues write that people who take aspirin are 23% less likely to die from a heart attack and taking it early on is critical.
The study team reviewed data from the 2011 National EMS Information System database. They focused on nearly 200,000 people under age 40 who reported chest pain to paramedics. Patients who had an electronic cardiogram or heart rate monitoring in the ambulance were included, while those with chest pain related to injuries were not. Overall, paramedics gave aspirin to about 45% of patients. Age and sex did not affect the odds of receiving aspirin.
Tataris noted that the study can't tell why paramedics failed to provide patients with aspirin. For instance, some patients might already be taking aspirin daily, or they might have a condition that prevents them from using it. Other patients might be more educated about the value of aspirin in case of heart attack or stroke, so some might already have taken aspirin before paramedics arrived.
The American Heart Association recommends that people with symptoms of a heart attack should first call 9-1-1 and ask the responder if they should take aspirin. The responder can help determine if there is any reason the person should not take aspirin, such as an allergy. For most people, however, aspirin is a safe intervention, as only 2% to 3% of the general population has an intolerance to it, the researchers write. Tataris agrees with this recommendation, saying that "the administration of aspirin should be discussed between the patient and their health care providers in an emergency situation."
[link url="http://www.reuters.com/article/2015/02/20/us-health-aspirin-heart-attack-idUSKBN0LO1YP20150220"]Full Reuters Health report[/link]
[link url="http://emj.bmj.com/content/early/2015/02/12/emermed-2014-204299.abstract?sid=a02d7273-aa9f-4d94-82dd-d0be4f1e4c72"]Emergency Medicine Journal abstract[/link]