Aspirin is an essential medicine before and after angioplasty or percutaneous coronary intervention (PCI). Previous studies suggest that pre-procedural aspirin is not administered to a clinically significant number of patients undergoing PCI.
The study population comprised 65,175 patients, of whom 4,640 (7.1%) did not receive aspirin within 24 h before undergoing PCI. Aspirin nonreceivers were more likely to have had previous gastrointestinal bleeding or to present with cardiogenic shock or after cardiac arrest. Absence of aspirin before PCI was associated with a higher rate of death (3.9% vs. 2.8%; p < 0.001) and stroke (0.5% vs. 0.1%; with no difference in need for transfusions. This association was consistent across multiple pre-specified subgroups.
Conclusions Lack of aspirin before PCI was associated with significantly increased in-hospital mortality and stroke. Our study results support the need for quality efforts focused on optimizing aspirin use before PCI.