Association between use of low-dose aspirin on hemoglobin levels and serum iron homeostasis in patients with acute coronary syndrome or ischemic stroke

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Background: Association between low-dose aspirin (LDA) and possible covert effects on hemoglobin (without overt bleeding) has been inconsistent. The current study was planned to assess the effects of LDA on hemoglobin level and serum iron status over a period of 6 months in nonanemic patients with acute coronary syndrome (ACS) or ischemic stroke. Methods: This was a hospital-based open cohort prospective study conducted on newly diagnosed patients with ACS or ischemic stroke discharged on secondary prophylaxis of LDA (<162 mg/day) The study period was 6 months of patient recruitment and 6 months of follow-up. Results: Out of originally recruited 81 patients, 52 were followed up for the entire 6 months. The mean age was 61.8 ± 8 years. In 43 (82.6%) patients, the hemoglobin level had a fall at 6 months from the baseline level. Male patients had a significant fall in hemoglobin levels while as females had an insignificant change. Anemia was detected in 20 (38%) cases at the end of 6 months. The incidence of anemia was 0.38 cases/180 days. A fall in serum ferritin was observed in 30 patients and a rise was observed in 22 patients. At the end of 6 months, serum ferritin fell to <20 μg/L in five patients, out of which two patients had serum ferritin <15 μg/L. Conclusion: The study provided insight about the effect of LDA on the hemoglobin level and serum iron profile among the patients who were started on LDA for the secondary prophylaxis.