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Take aspirin or not? Simple test to decide

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IANS Washington
Last Updated : May 10 2014 | 4:09 PM IST

Pop an aspirin daily to prevent heart attack just on your friend's advise? Slow down as researchers have now devised a simple test that can measure plaque in arteries of heart to help doctors better determine who will benefit from the use of aspirin therapy.

Your coronary artery calcium (CAC) score - a measurement of plaque in the arteries that feed the heart - decides 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. Individuals with known CVD (cardiovascular disease) should take a daily aspirin, but the best approach for individuals without known CVD is unclear," said Michael D. Miedema from Minneapolis Heart Institute Foundation, US.

According to him, 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.

In this significant study, researchers studied 4,229 participants including those who had no known CVD or diabetes, were not on aspirin therapy, and were followed for approximately seven years.

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They estimated that participants with elevated CAC scores were two-four times more likely to benefit from aspirin therapy than to be harmed.

Conversely, participants with no calcified plaque were two-four times more likely to be harmed by aspirin use than to benefit.

The results in both the groups held true even after accounting for traditional risk factors.

Aspirin helps prevent heart attacks and strokes by preventing blood clots from forming in arteries lined with unhealthy plaque build-up.

However, this same benefit puts patients taking aspirin at risk for dangerous bleeding, when blood clots do not form where they should.

"If you don't have any calcified plaque, then 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 cautioned.

The study has been published in the journal Circulation: Cardiovascular Quality and Outcomes.

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First Published: May 10 2014 | 12:46 PM IST

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