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!
Mobile phone test can reveal vision problems in time
11.02.2016 | University of Gothenburg
Proteomics and precision medicine
08.02.2016 | University of Iowa Health Care
Today, plants and microorganisms are heavily used for the production of medicinal products. The production of biopharmaceuticals in plants, also referred to as “Molecular Pharming”, represents a continuously growing field of plant biotechnology. Preferred host organisms include yeast and crop plants, such as maize and potato – plants with high demands. With the help of a special algal strain, the research team of Prof. Ralph Bock at the Max Planck Institute of Molecular Plant Physiology in Potsdam strives to develop a more efficient and resource-saving system for the production of medicines and vaccines. They tested its practicality by synthesizing a component of a potential AIDS vaccine.
The use of plants and microorganisms to produce pharmaceuticals is nothing new. In 1982, bacteria were genetically modified to produce human insulin, a drug...
Atomic clock experts from the Physikalisch-Technische Bundesanstalt (PTB) are the first research group in the world to have built an optical single-ion clock which attains an accuracy which had only been predicted theoretically so far. Their optical ytterbium clock achieved a relative systematic measurement uncertainty of 3 E-18. The results have been published in the current issue of the scientific journal "Physical Review Letters".
Atomic clock experts from the Physikalisch-Technische Bundesanstalt (PTB) are the first research group in the world to have built an optical single-ion clock...
The University of Würzburg has two new space projects in the pipeline which are concerned with the observation of planets and autonomous fault correction aboard satellites. The German Federal Ministry of Economic Affairs and Energy funds the projects with around 1.6 million euros.
Detecting tornadoes that sweep across Mars. Discovering meteors that fall to Earth. Investigating strange lightning that flashes from Earth's atmosphere into...
Physicists from Saarland University and the ESPCI in Paris have shown how liquids on solid surfaces can be made to slide over the surface a bit like a bobsleigh on ice. The key is to apply a coating at the boundary between the liquid and the surface that induces the liquid to slip. This results in an increase in the average flow velocity of the liquid and its throughput. This was demonstrated by studying the behaviour of droplets on surfaces with different coatings as they evolved into the equilibrium state. The results could prove useful in optimizing industrial processes, such as the extrusion of plastics.
The study has been published in the respected academic journal PNAS (Proceedings of the National Academy of Sciences of the United States of America).
Exceeding critical temperature limits in the Southern Ocean may cause the collapse of ice sheets and a sharp rise in sea levels
A future warming of the Southern Ocean caused by rising greenhouse gas concentrations in the atmosphere may severely disrupt the stability of the West...
12.02.2016 | Event News
09.02.2016 | Event News
02.02.2016 | Event News
12.02.2016 | Physics and Astronomy
12.02.2016 | Life Sciences
12.02.2016 | Medical Engineering