Aspirin: Is It Safe to Stop It Early? 09/01/25
Welcome to Cardiology Today â Recorded September 01, 2025. This episode summarizes 5 key cardiology studies on topics like stent implantation and community health workers. Key takeaway: Aspirin: Is It Safe to Stop It Early?.
Article Links:
Article 1: Home-Based Care for Hypertension in Rural South Africa. (The New England journal of medicine)
Article 2: Ticagrelor and Aspirin or Aspirin Alone after Coronary Surgery for Acute Coronary Syndrome. (The New England journal of medicine)
Article 3: Early Discontinuation of Aspirin after PCI in Low-Risk Acute Myocardial Infarction. (The New England journal of medicine)
Article 4: Aspirin in Patients with Chronic Coronary Syndrome Receiving Oral Anticoagulation. (The New England journal of medicine)
Article 5: Early Withdrawal of Aspirin after PCI in Acute Coronary Syndromes. (The New England journal of medicine)
Full episode page: https://podcast.explainheart.com/podcast/aspirin-is-it-safe-to-stop-it-early-09-01-25/
đ Featured Articles
Article 1: Home-Based Care for Hypertension in Rural South Africa.
Journal: The New England journal of medicine
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/40888742
Summary: This open-label trial in South Africa investigated a home-based hypertension care model involving patient blood pressure monitoring, community health worker home visits for data collection and medication delivery, and remote nurse-led decision making. The intervention significantly improved blood pressure control compared to usual care, demonstrating the effectiveness of community-based strategies in managing hypertension in resource-limited settings. This approach holds promise for expanding access to and improving hypertension management in similar populations.
Article 2: Ticagrelor and Aspirin or Aspirin Alone after Coronary Surgery for Acute Coronary Syndrome.
Journal: The New England journal of medicine
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/40888737
Summary: This registry-based clinical trial assessed whether adding ticagrelor to aspirin, compared with aspirin alone, reduces cardiovascular events after coronary-artery bypass grafting for acute coronary syndrome. The study found no significant difference in the composite outcome of all-cause mortality, myocardial infarction, stroke, or repeat revascularization between the ticagrelor-aspirin and aspirin-only groups at one year. Therefore, aspirin monotherapy appears sufficient for most patients following coronary artery bypass grafting post acute coronary syndrome.
Article 3: Early Discontinuation of Aspirin after PCI in Low-Risk Acute Myocardial Infarction.
Journal: The New England journal of medicine
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/40888726
Summary: This multicenter trial examined early aspirin discontinuation after percutaneous coronary intervention in acute myocardial infarction patients deemed low-risk. Patients who discontinued aspirin after one week and continued P2Y12 inhibitor monotherapy had similar rates of major adverse cardiovascular events compared to those receiving twelve months of dual antiplatelet therapy. This suggests that early aspirin withdrawal may be a safe strategy in select low-risk acute myocardial infarction patients undergoing percutaneous coronary intervention.
Article 4: Aspirin in Patients with Chronic Coronary Syndrome Receiving Oral Anticoagulation.
Journal: The New England journal of medicine
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/40888725
Summary: This randomized, placebo-controlled trial evaluated the role of aspirin in chronic coronary syndrome patients on long-term oral anticoagulation after previous stent implantation. The addition of aspirin to oral anticoagulation did not significantly reduce the risk of thrombotic events but did significantly increase the risk of major bleeding. These findings support the strategy of avoiding aspirin in chronic coronary syndrome patients already receiving oral anticoagulants.
Article 5: Early Withdrawal of Aspirin after PCI in Acute Coronary Syndromes.
Journal: The New England journal of medicine
PubMed Link: https://pubmed.ncbi.nlm.nih.gov/40888723
Summary: This study investigated whether P2Y12 inhibitor monotherapy without aspirin, initiated shortly after successful percutaneous coronary intervention, is effective and safe for patients with acute coronary syndromes. Early aspirin withdrawal and P2Y12 inhibitor monotherapy, compared to standard dual antiplatelet therapy, resulted in similar rates of the primary composite outcome of death, myocardial infarction, stroke, or major bleeding. Thus, early aspirin cessation with P2Y12 inhibitor monotherapy appears non-inferior to dual antiplatelet therapy in acute coronary syndrome patients post percutaneous coronary intervention.
đ Transcript
Today’s date is September 01, 2025. Welcome to Cardiology Today. Here are the latest research findings.
Article number one. Home-Based Care for Hypertension in Rural South Africa. This open-label trial in South Africa investigated a home-based hypertension care model involving patient blood pressure monitoring, community health worker home visits for data collection and medication delivery, and remote nurse-led decision making. The intervention significantly improved blood pressure control compared to usual care, demonstrating the effectiveness of community-based strategies in managing hypertension in resource-limited settings. This approach holds promise for expanding access to and improving hypertension management in similar populations.
Article number two. Ticagrelor and Aspirin or Aspirin Alone after Coronary Surgery for Acute Coronary Syndrome. This registry-based clinical trial assessed whether adding ticagrelor to aspirin, compared with aspirin alone, reduces cardiovascular events after coronary-artery bypass grafting for acute coronary syndrome. The study found no significant difference in the composite outcome of all-cause mortality, myocardial infarction, stroke, or repeat revascularization between the ticagrelor-aspirin and aspirin-only groups at one year. Therefore, aspirin monotherapy appears sufficient for most patients following coronary artery bypass grafting post acute coronary syndrome.
Article number three. Early Discontinuation of Aspirin after Percutaneous Coronary Intervention in Low-Risk Acute Myocardial Infarction. This multicenter trial examined early aspirin discontinuation after percutaneous coronary intervention in acute myocardial infarction patients deemed low-risk. Patients who discontinued aspirin after one week and continued P2Y12 inhibitor monotherapy had similar rates of major adverse cardiovascular events compared to those receiving twelve months of dual antiplatelet therapy. This suggests that early aspirin withdrawal may be a safe strategy in select low-risk acute myocardial infarction patients undergoing percutaneous coronary intervention.
Article number four. Aspirin in Patients with Chronic Coronary Syndrome Receiving Oral Anticoagulation. This randomized, placebo-controlled trial evaluated the role of aspirin in chronic coronary syndrome patients on long-term oral anticoagulation after previous stent implantation. The addition of aspirin to oral anticoagulation did not significantly reduce the risk of thrombotic events but did significantly increase the risk of major bleeding. These findings support the strategy of avoiding aspirin in chronic coronary syndrome patients already receiving oral anticoagulants.
Article number five. Early Withdrawal of Aspirin after Percutaneous Coronary Intervention in Acute Coronary Syndromes. This study investigated whether P2Y12 inhibitor monotherapy without aspirin, initiated shortly after successful percutaneous coronary intervention, is effective and safe for patients with acute coronary syndromes. Early aspirin withdrawal and P2Y12 inhibitor monotherapy, compared to standard dual antiplatelet therapy, resulted in similar rates of the primary composite outcome of death, myocardial infarction, stroke, or major bleeding. Thus, early aspirin cessation with P2Y12 inhibitor monotherapy appears non-inferior to dual antiplatelet therapy in acute coronary syndrome patients post percutaneous coronary intervention.
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đ Keywords
stent implantation, community health workers, aspirin, home-based care, blood pressure control, rural health, P2Y12 inhibitor, oral anticoagulation, coronary-artery bypass grafting, bleeding risk, hypertension, antiplatelet therapy, drug-eluting stent, ticagrelor, acute coronary syndrome, dual antiplatelet therapy, percutaneous coronary intervention, acute myocardial infarction, acute coronary syndromes, chronic coronary syndrome, aspirin withdrawal.
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Concise summaries of cardiovascular research for professionals.
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