Patients with cancer should receive the same aspirin therapy if admitted for suspected acute myocardial infarction as patients without cancer, according to an article published online December 13, 2006 by the journal Cancer.

In the current study, investigators at a major US cancer center found that 9 of 10 cancer patients with low platelet counts who were admitted for an acute myocardial infarction and did not receive aspirin died, whereas only 1 patient died in a group of 17 similar cancer patients who received aspirin under the same circumstances. They also determined that aspirin helps cancer patients with normal platelet counts survive myocardial infarctions similarly to the benefits seen in healthy people with normal platelet counts.

According to the World Health Organization there are approximately 10 million cancer patients worldwide, of whom1.5 million may develop blood clots during their cancer treatment and, as such, are at a much higher risk of dying from heart disease if not treated properly. "Now that we have this study, it would be a travesty if you survive treatment for cancer only to die of a heart attack soon thereafter," said Jean-Bernard Durand, the senior author.

He and anesthesiologist Mona Sarkiss, MD, PhD, made the observation that patients with thrombocytopenia who had a myocardial infarction and were treated in the intensive care unit at M. D. Anderson tended to die more often when they were not given aspirin. However, they noted that some patients given aspirin and/or beta-blockers had "great" clinical outcomes. "Because no practice guidelines exist, physicians were treating their patients with great variability and the disparity was obvious," Durand said.

Sarkiss, who is the study's lead author, Durand, and a team of researchers which included investigators from Baylor College of Medicine and Duke University Medical Center, conducted a retrospective analysis of cancer patients treated at M. D. Anderson Cancer Center in 2001. The 70 patients were divided into two groups based on their platelet counts and data was collected on the use of aspirin, bleeding complications, and survival.

They found that patients with acute myocardial infarction and low platelets who did not receive aspirin had a seven-day survival rate of 6 percent compared with 90 percent for those who received aspirin. There were no severe bleeding complications in patients who used aspirin. Conversely, patients with low platelet counts who formed a blood clot and were not exposed to aspirin died.

The beneficial effect of aspirin also was seen in patients with normal platelet counts. Seven-day survival was 88 percent in aspirin-treated patients compared with 45 percent in patients who did not receive aspirin.

Durand observed that these deaths rates are abnormally high. "In the non-cancer patient with acute coronary syndrome anywhere in the United States, an expected seven-day mortality is less than 1 percent."