Myocardial Infarction Quality Indicators
Aspirin at Discharge
According to the US Preventive Services Task Force, aspirin is recommended to decrease the incidence (frequency of new cases) of heart disease in adults who have risk factors for heart disease. Individuals who are at increased risk for bleeding, however, may not be candidates for aspirin therapy because aspirin thins the blood, further increasing the risk of bleeding.
The American College of Cardiology/American Heart Association Task Force on Practice Guidelines found Class I evidence (highest level of scientific support) for taking aspirin indefinitely after a heart attack. (Circulation, September, 2000: 102 (10); 1193-1209)
Evidence for this guideline has existed since the mid-to late 1990s and has been further supported by subsequent research. "Long-term aspirin therapy confers conclusive net benefits on risk of subsequent MI [myocardial infarction], stroke, and vascular death among patients with a wide range of prior manifestations of cardiovascular disease." (Circulation, October 21, 1997: 96(8); 2751-2753)
Do UVa physicians advise and prescribe a daily aspirin regimen to eligible patients?
Yes. For the most recent 12-month period ending March 31, 2006, 99 percent of eligible heart attack patients discharged from UVa received a prescription for aspirin. This is compared to 91 percent of patients across Virginia and 89 percent of patients nationwide, as documented by the Hospital Quality Alliance, a Center for Medicaid and Medicare Services program.
