Impact of Long-Term Aspirin Use on Cardiovascular Disease Prevention and Bleeding Risks

Background: The advantages of long-term aspirin usage for preventing cardiovascular disease must be balanced against the danger of bleeding. Objective: This study aimed to evaluate the impact of long-term aspirin therapy on cardiovascular disease prevention and to assess the associated risks of bleeding complications. Methodology: A prospective cohort research comprising 270 adult patients aged 40 and above who were on long-term aspirin treatment was carried out at the University of the Punjab from January 2023 to December 2023. A minimum of six months of aspirin treatment for primary or secondary cardiovascular prevention was necessary to meet the inclusion criteria. With an emphasis on cardiovascular outcomes, bleeding problems, and pertinent laboratory indicators, we gathered data via patient interviews, medical record checks, and laboratory testing. Frequency distributions and t-tests were used in statistical studies to contrast aspirin users with non-users. Results: Among the 270 participants, 25 aspirin users (11.90%) experienced gastrointestinal bleeding (GI Bleeding), while no non-users reported this complication. Additionally, 10 aspirin users (4.76%) had intracranial hemorrhage, whereas no cases were observed in the non-user group. Laboratory analyses revealed that aspirin users had significantly higher platelet counts (230 ± 40 x10^9/L) compared to non-users (210 ± 35 x10^9/L, p = 0.01) and longer prothrombin times (14.2 ± 1.5 seconds) compared to non-users (13.5 ± 1.2 seconds, p = 0.03). Hemoglobin levels were not significantly different between aspirin users (13.2 ± 1.8 g/dL) and non-users (13.8 ± 1.9 g/dL, p = 0.12). Conclusion: Long-term aspirin usage successfully lowers the risk of cardiovascular events, but it also raises the risk of bleeding in the brain and gastrointestinal tract. These results emphasize the need of doing a thorough risk assessment before beginning long-term aspirin medication in patients.