Rationality and safety of acetylsalicylic acid therapy in centenarians

Aim . To assess the presence or absence of indications for taking acetylsalicylic acid (ASA), as well as the safety of therapy among centenarians according to clinical guidelines. Materials and methods . The study included 81 patients (71 women and 10 men). Inclusion criteria: patients 95 years and older (mean age 98.3 ± 1.89) receiving combination therapy, including ASA. In the study, the patients' history data on concomitant diseases and pharmacotherapy were assessed, a comprehensive examination (complete blood count (CBC), echocardiography) was performed. In our work, the results of these studies were analyzed, and statistical calculations were performed. Results . From the total number of patients included in the study, 41.9% regularly take ASA (n=34). In 41.7% (n=14) were taken as secondary prevention of cardiovascular events (the presence of a documented history of cardiovascular disease). According to current recommendations, 58.3% (n=20) of patients had no indications for a prescription. During the analysis among patients for whom according to clinical guidelines ASA therapy was not recommended, groups were identified in which the risk of gastrointestinal bleeding (GIB) was increased: 30% (n=6) patients had a history of gastric ulcer or duodenal ulcer, 20% (n=4) took drugs from the group of non-steroidal anti-inflammatory drugs, 25% (n=3) of patients had thrombocytopenia. In 4 (15.6%) patients from these subgroups, several factors simultaneously increase gastrointestinal bleeding risk. Conclusions . From the total number of patients included in the study and prescribed with ASA, more than half had no indications for therapy; the vast majority of this group had additional risk factors for GIB development. At the same time, a quarter of all participants had indications, but therapy was not prescribed. Summarizing all of the mentioned above, before prescribing and continuing treatment with ASA, clinicians should analyze the therapy's feasibility and safety.