Cardiac Screening Test May Help Determine Who Should Take Aspirin to Prevent Heart Attack
A study involving the Minneapolis Heart Institute Foundation shows that a simple test to measure plaque in the arteries of the heart may help doctors better determine who will and will not benefit from use of aspirin therapy to prevent heart disease.
For over 30 years, aspirin has been known to prevent heart attacks and strokes, but who exactly should take a daily aspirin remains unclear. New research published today in Circulation: Cardiovascular Quality and Outcomes shows that your coronary artery calcium (CAC) score, a measurement of plaque in the arteries that feed the heart, may help determine whether or not you are a good candidate for aspirin.
“Many heart attacks and strokes occur in individuals who do not appear to be at high risk,” states lead author, Michael D Miedema, MD, MPH. “Individuals with known CVD [cardiovascular disease] should take a daily aspirin, but the best approach for individuals without known CVD is unclear.
If we only treat high-risk individuals with aspirin, we are going to miss a substantial portion of patients who eventually suffer heart attacks. However, liberally prescribing aspirin increases the bleeding risk for a significant number of people who were never going to have a heart attack in the first place. With this study, we wanted to see if there is potentially a better way to determine who to treat with aspirin beyond simply using traditional risk factors.”
Aspirin helps prevent heart attacks and strokes by preventing blood clots from forming in arteries lined with unhealthy plaque buildup. However, this same benefit puts patients taking aspirin at risk for dangerous bleeding, when blood clots don’t form where they should. For that reason, the American Heart Association (AHA) guidelines currently recommend aspirin to prevent cardiovascular disease (CVD) in people who have known CVD or who are considered to be at high risk for a CVD event. Aspirin is generally not recommended for people who are considered to be at low or intermediate risk.
In this retrospective study, researchers studied 4,229 participants in the Multi-Ethnic Study of Atherosclerosis (MESA) from six centers across the country. Participants included had no known CVD or diabetes, were not on aspirin therapy, and were followed for approximately 7 years.
Participants were grouped according to their CAC score and the rates of heart attacks in each group were calculated. Based on these rates, the research team weighed the likelihood of an individual to benefit from aspirin therapy (the potential of the aspirin to prevent a heart attack) against the likelihood of harm (the potential for the aspirin to cause major bleeding).
They estimated that participants with elevated CAC scores (>100) were 2−4 times more likely to benefit from aspirin therapy than to be harmed, even if they did not qualify for aspirin use according to current AHA guidelines. Conversely, MESA participants with no calcified plaque (CAC score = 0) were 2−4 times more likely to be harmed by aspirin use than to benefit. The results in both groups held true even after accounting for traditional risk factors.
“We estimate that individuals with significant plaque buildup in the arteries of the heart are much more likely to prevent a heart attack with aspirin use than to suffer a significant bleed” explains Miedema. “On the opposite end of the spectrum, if you don’t have any calcified plaque, our estimations indicate that use of aspirin would result in more harm than good, even if you have risk factors for heart disease such as high cholesterol or a family history of the disease.”
Miedema added, “A CAC score of zero is associated with a very low risk of having a heart attack. That means individuals with a score of zero may not benefit from preventive medications, such as aspirin as well as the cholesterol-lowering statin medications. Approximately 50% of middle-aged men and women have a CAC score of zero, so there is a potential for this test to personalize the approach to prevention and allow a significant number of patients to avoid preventive medications, but we need further research to verify that routine use of this test is the best option for our patients.”
Michael Miedema is a preventative cardiologist at the Minneapolis Heart Institute® at Abbott Northwestern Hospital and a clinical investigator with the Minneapolis Heart Institute Foundation (MHIF). The full study results are published in Circulation: Cardiovascular Quality and Outcomes HERE.
Jackie Boucher | Eurek Alert!
Exploring a new frontier of cyber-physical systems: The human body
18.05.2015 | National Science Foundation
Soft-tissue engineering for hard-working cartilage
18.05.2015 | Technische Universitaet Muenchen
Physicists have developed an innovative method that could enable the efficient use of nanocomponents in electronic circuits. To achieve this, they have developed a layout in which a nanocomponent is connected to two electrical conductors, which uncouple the electrical signal in a highly efficient manner. The scientists at the Department of Physics and the Swiss Nanoscience Institute at the University of Basel have published their results in the scientific journal “Nature Communications” together with their colleagues from ETH Zurich.
Electronic components are becoming smaller and smaller. Components measuring just a few nanometers – the size of around ten atoms – are already being produced...
Development and implementation of an advanced automobile parking navigation platform for parking services
To fulfill the requirements of the industry, PolyU researchers developed the Advanced Automobile Parking Navigation Platform, which includes smart devices,...
The world's first electrical car and passenger ferry powered by batteries has entered service in Norway. The ferry only uses 150 kWh per route, which...
On Tuesday, 19 May 2015 the research icebreaker Polarstern will leave its home port in Bremerhaven, setting a course for the Arctic. Led by Dr Ilka Peeken from the Alfred Wegener Institute, Helmholtz Centre for Polar and Marine Research (AWI) a team of 53 researchers from 11 countries will investigate the effects of climate change in the Arctic, from the surface ice floes down to the seafloor.
RV Polarstern will enter the sea-ice zone north of Spitsbergen. Covering two shallow regions on their way to deeper waters, the scientists on board will focus...
Nanoengineers at the University of California, San Diego developed a gel filled with toxin-absorbing nanosponges that could lead to an effective treatment for skin and wound infections caused by MRSA (methicillin-resistant Staphylococcus aureus), an antibiotic-resistant bacteria. This "nanosponge-hydrogel" minimized the growth of skin lesions on mice infected with MRSA - without the use of antibiotics. The researchers recently published their findings online in Advanced Materials.
To make the nanosponge-hydrogel, the team mixed nanosponges, which are nanoparticles that absorb dangerous toxins produced by MRSA, E. coli and other...
20.05.2015 | Event News
18.05.2015 | Event News
12.05.2015 | Event News
22.05.2015 | Materials Sciences
22.05.2015 | Information Technology
22.05.2015 | Materials Sciences