Health Canada has endorsed Aspirin as an emergency treatment for heart attacks. Photo: iStock photo In the latest claim for a century-old drug, Health Canada is allowing the makers of Aspirin to market its drug as an emergency treatment for heart attacks.
The federal drug regulator will permit drug giant Bayer Inc. to state on the package insert for low-dose Aspirin, and in advertisements, “If you think you are having a heart attack, call 911 immediately and then chew or crush and swallow two Aspirin 81 mg tablets. Taking Aspirin 81 mg at the first signs and symptoms can reduce your risk of dying of a heart attack.”
Experts say it has been known for a decade or longer that chewing Aspirin can lower the risk of death from heart attacks by helping dissolve clots that have lodged in coronary arteries.
“The difference now is that the manufacturer of Aspirin has got permission to put that on the label,” said Dr. Andrew Pipe, chief of the division of prevention and rehabilitation at the University of Ottawa Heart Institute.
Health Canada said that it does not provide medical advice, and that patients “should speak with a health care practitioner regarding their medical conditions and to seek treatment options.”
The agency said the new claim for heart attacks appears on the revised product monograph for Aspirin. “Other companies can apply for the claim with the appropriate evidence,” the agency said in an email.
Pipe, who has no relationship with Bayer, said Aspirin works on platelets — small cells in blood that, when they stick together, form clots to stop bleeding.
But platelets can also congeal around a damaged blood vessel. With heart attacks, plaque inside a diseased or damaged artery wall ruptures and is released into the blood stream, stimulating an “almost instantaneous” blood clot that reduces blood flow and oxygen to the heart muscle, Pipe said.
“Anything we can do to reduce or dissolve that clot will be very beneficial — and we know the best and most rapid way to stop these platelets from sticking to each other is for somebody to chew Aspirin,” Pipe said.
Aspirin’s anti-platelet effect occurs at doses lower than the standard, 325 mg dose of the pain reliever, and chewable tablets are absorbed into the bloodstream more rapidly than crushing and swallowing enteric-coated tablets, doctors say.
Paramedics administer Aspirin if they suspect someone is having a heart attack and Aspirin is part of the standard orders emergency doctors give for suspected heart attacks, said Dr. Alan Bell, an assistant professor in the department of family and community medicine at the University of Toronto and chair of the Canadian Cardiovascular Society’s anti-platelet guidelines committee.
“The earlier you get it in, the better,” said Bell, who was paid an honorarium by Bayer to speak to media.
“Canadians like to be prepared for stuff,” Bell said. “We’re well prepared for ice storms and power outages. We should be prepared for heart attacks, too.”
“Having Aspirin available at home, in your first aid kit, in your car — wherever — can save your life or the life of somebody close to you,” Bell said.
An estimated 70,000 heart attacks occur each year in Canada and almost 16,000 Canadians die each year as a result of a heart attack. Risk factors include diabetes, high blood pressure and high cholesterol.
In May, the U.S. Food and Drug Administration rejected a bid by Bayer to market daily, low-dose Aspirin in the U.S. as primary prevention against a first heart attack in people with no known history of heart trouble.
The Canadian claim differs, because it involves using Aspirin in a single dose during an actual, acute heart attack.
The claim was approved specifically for branded Bayer Aspirin. But Pipe, of the Ottawa Heart Institute, said generic ASA, or acetylsalicylic acid, the active ingredient in Aspirin, works just as well.
Symptoms of a heart attack include chest pain, sweating, nausea, shortness of breath, light-headedness and pain in the neck, jaw, shoulders, arm or back.
In 2013, Bayer had sales of $1.6 billion in Canada.
skirkey@postmedia.com
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