ASPIRIN USE REDUCES ALL-CAUSE MORTALITY IN PATIENTS WITH KNOWN OR
SUSPECTED CAD
Among individuals being evaluated for known or suspected coronary
artery disease, daily aspirin use is associated with a reduction
of more than a third in long-term all-cause mortality, especially
among the elderly, those with impaired exercise tolerance, and those
with known coronary artery disease.
CELL PHONE HEALTH RISK CANNOT BE DISMISSED, WHO SAYS
A link between mobile phone usage and cancer should not be summarily
dismissed, an official at a World Health Organization agency said.
Aspirin Use Reduces All-Cause Mortality in Patients With Known or
Suspected CAD
WESTPORT, CT (Reuters Health) Sept 11 - Among individuals being
evaluated for known or suspected coronary artery disease, daily
aspirin use is associated with a reduction of more than a third
in long-term all-cause mortality, especially among the elderly,
those with impaired exercise tolerance, and those with known coronary
artery disease, according to results from an observational study
by Cleveland Clinic Foundation researchers.
Senior investigator Dr. Michael S. Lauer and colleagues conducted
a propensity analysis that compared all-cause mortality in a group
of 1351 aspirin users to that in 1351 non-aspirin users. In an interview
with Reuters Health, Dr. Lauer said that aspirin use was associated
with "between a 30% and 50% reduction in all-cause mortality."
The results are reported in The Journal of the American Medical
Association for September 12.
All patients included in the analysis were recruited from a cohort
of 6174 consecutive patients who were referred to the Cleveland
Clinic for stress echocardiography. The propensity analysis design
allowed for patients to be prospectively enrolled in the study.
"These patients are in all respects the same with the sole
difference being aspirin use," said Dr. Lauer. The median length
of follow-up was 3.1 years.
The authors write that "during follow-up, 153 (6%) patients
died. Aspirin use was associated with a lower risk of death (4%
vs 8%, p = 0.002)." The three patient characteristics most
strongly correlated with a large absolute mortality benefit were
older age, impaired exercise capacity, and a history of known coronary
disease."
Dr. Lauer said the finding that aspirin is especially beneficial
in patients who are out of shape is "a real take-home message
for physicians." There is a well-established correlation between
physical conditioning and mortality, he pointed out.
"Now, we actually have a treatment for the out-of-condition
patient. We can tell the patient to take an aspirin," said
Dr. Lauer. "That won't get them in shape, but it may save their
lives."
American Heart Association president Dr. David Faxon said the finding
that aspirin reduces all-cause mortality "is a really solid
endpoint, easier to establish than reduction in cardiovascular mortality."
But Dr. Faxon said an "even more powerful message" is
the finding about physical condition and aspirin use.
In an editorial that accompanies the study , Drs. Martha J. Radford
and JoAnne M. Foody of Yale New Haven Health System, in Connecticut,
write that observational studies based on sophisticated techniques
such as propensity analysis make a convincing case for expanding
aspirin use to unstudied groups.
JAMA 2001;286:1187-1194, 1228-1229.
Cell Phone Health Risk Cannot Be Dismissed, WHO Says
HELSINKI (Reuters Health) Sept 07 - A link between mobile phone
usage and cancer should not be summarily dismissed, an official
at a World Health Organization agency said on Friday.
"More research is needed," Elisabeth Cardis, Chief of
Radiation and Cancer at the WHO's International Agency for Research
in Cancer, told a conference in Helsinki.
The explosive growth in mobile phone use, particularly in Europe
and the United States, has increased the public debate over possible
health risks linked to mobile phones. While a few studies claim
there is a connection, most authoritative studies have not been
able to conclude that regular mobile phone usage could damage a
person's brain.
"Based on current epidemiological evidence, there is no evidence
of a strong association between RF [radio frequency] exposure and
cancer," Cardis said. "One can't rule out that there is
a risk, but if there is a risk to mobile phone users it would be
very small."
Cardis said research by the INTERPHONE study group would focus
on a link between cancer and cellular telephones. She said this
would be more thorough than previous studies because it would span
a period of 3 years and would go into more detail, such as research
into lower-frequency electromagnetic fields to and from phones.
The INTERPHONE study results should be ready in 2004.
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