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 Aspirin Update Session at KIHD Symposium
All high risk patients need to be put on low dose
Aspirin Therapy to reduce morbidity and mortality
Aspirin cannot prevent IHD but it can reduce
Athero Thrombotic events - Fawad Farooq
It is extremely useful in pre-eclampsia besides
many other gynecological disorders - Dr. Saira Aziz Siddiqui

KARACHI: In order to create awareness among the healthcare professionals and promote the use of Low Dose Aspirin therapy in various well established indications, An Aspirin Update session was organized by Pakistan Aspirin Foundation during KIHD symposium on Saturday morning February 10th 2023. It was chaired by Prof. Abdus Samad while the members of the panel of experts included Prof.M.Ishaq, Prof. Mansoor Ahmad, Prof.Feroz Memon, Prof. Rashid Khan, Prof.Abid Amin and Prof. Javed Akbar Seyal. Prof. Fawad Farooq from NICVD and Dr. Saira Aziz Siddiqui, assistant professor of obstetrics & Gynaecology at DUHS were the two guest speakers.

 Prof. Fawad Farooq

Dr. Saira Aziz spoke on use of low dose Aspirin therapy in pregnancy. She pointed out that Aspirin was being used as prophylaxis in pregnancy, in patients with still birth, fetal growth restrictions, pre term births, frequent pregnancy loss as well. Women at high risk of developing pre eclampsia are also put on low dose aspirin therapy on regular basis. It must be stated before 12th week of pregnancy. Women suffering from Type-2 diabetes have high risk of developing other risk factors. Adverse pregnancy outcome is not a modifiable risk factor. One should continue aspirin till the 36th week of pregnancy. Start with 150mg for first few weeks and then continue with 75-81mg till the 36th week of pregnancy some studies have used 100mg dose as well. She laid emphasis that women must adhere to Aspirin therapy and then also highlighted some of the reasons for non-adherence which included forgetting to take it or the pill burden as they also have to take some other drugs.

Members of the Panel of Experts during the session siting on the Dais shows from (L to R)
Prof. Abdus Samad, Prof. Ishaq , Prof. Mansoor Ahmed, Prof. Feroz Memon,
Prof. Nawaz Lashari and Prof. Rashid Khan.
 

In case of pre- term labour the Aspirin trial used 75mg dose, it was started from sixth to thirteen week of pregnancy which significantly reduced the pre-term delivery. Aspirin has also been found quite useful in various gynecological malignancies and it did increase survival. Aspirin is also being routinely used in sub-fertility cases, she remarked.

Prof. Fawad Farooq in his presentation discussed in detail the rational use of antiplatelet therapy, assessment of cardiovascular diseases and bleeding risk and shared the present evidence available. CVD, he said is a progressive disease. Plaque rupture creates problems. He referred to the adhesions of platelets, their activation and then aggregation in the arteries. There is a long list of well-established indications for the use of low dose aspirin therapy, including primary and secondary prevention. Aspirin, he further stated, cannot prevent IHD but it can reduce the athero thrombotic events. While prescribing Aspirin one should always weight the risks and benefits. It is important that all high risk patients are put on low dose aspirin therapy if there is no contra indication. He also referred to various trials and shared their results. He was of the view that it is important that we look at the age of the patient. In case the patients are between 40-59 years of age, always discuss with the patient.

Pakistan Aspirin Foundation organized a Session on Aspirin Update during the Dr.Abdul Haq
Cardiology Symposium organized by Karachi Institute of Heart Diseases. Group photograph
taken on the occasion shows the members of Panel of Experts alongwith some
of the senior cardiologists and physicians present on this occasion.

Almost all the panelists also favoured the use of low dose aspirin therapy in high risk patients. Bleeding risk should also be considered as first it is important to do no harm. Prof. Ishaq and Prof. Mansoor Ahmad remarked that people are using Aspirin for the last twenty five years or more but there are no reported side effects or bleeding risks. As a precautionary measure, one can add PPIs with aspirin therapy. It is an extremely safe antiplatelet agent which reduces morbidity and mortality in various disorders significantly.
In his concluding remarks Prof Abdus Samad said that the cardiovascular disease burden has increased. There is an enormous increase in the number of primary angioplasties being performed in the country. Patients survive, some develop heart failure and some complain of stable, unstable angina. We need to concentrate on prevention of diseases, Hence it is essential that we act before the event takes place. It is only possible if we promote the use of low dose aspirin therapy in primary prevention. There has been an increase in patients suffering from sudden cardiac death, hence preventive measures should get preference which is also beneficial and cost effective, he remarked.

Dr. Saira Aziz

Earlier Mr.Shaukat Ali Jawaid General Secretary Paksitan Aspirin Foundation welcomed the speakers, panelists and participants to the meeting. He also thanked M/s Atco Laboratories for continuously sponsoring the CME activities and such academic events for the last many years despite the fact that keeping up professional ethics, we do not promote any particular company and a brand name. Mr. Akhtar Director Marketing and Sales from Atco also briefly addressed the meeting and thanked all the speakers, members of the Expects Panel and KIHD administration for providing them an opportunity to organize this session.