Featured Research

from universities, journals, and other organizations

Cardiac screening test may help determine who should take aspirin to prevent heart attack

Date:
May 9, 2014
Source:
Minneapolis Heart Institute Foundation
Summary:
'Many heart attacks and strokes occur in individuals who do not appear to be at high risk,' researchers report following a recent study. '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.'

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."


Story Source:

The above story is based on materials provided by Minneapolis Heart Institute Foundation. Note: Materials may be edited for content and length.


Journal Reference:

  1. M. D. Miedema, D. A. Duprez, J. R. Misialek, M. J. Blaha, K. Nasir, M. G. Silverman, R. Blankstein, M. J. Budoff, P. Greenland, A. R. Folsom. Use of Coronary Artery Calcium Testing to Guide Aspirin Utilization for Primary Prevention: Estimates From the Multi-Ethnic Study of Atherosclerosis. Circulation: Cardiovascular Quality and Outcomes, 2014; DOI: 10.1161/%u200BCIRCOUTCOMES.113.000690

Cite This Page:

Minneapolis Heart Institute Foundation. "Cardiac screening test may help determine who should take aspirin to prevent heart attack." ScienceDaily. ScienceDaily, 9 May 2014. <www.sciencedaily.com/releases/2014/05/140509172919.htm>.
Minneapolis Heart Institute Foundation. (2014, May 9). Cardiac screening test may help determine who should take aspirin to prevent heart attack. ScienceDaily. Retrieved October 20, 2014 from www.sciencedaily.com/releases/2014/05/140509172919.htm
Minneapolis Heart Institute Foundation. "Cardiac screening test may help determine who should take aspirin to prevent heart attack." ScienceDaily. www.sciencedaily.com/releases/2014/05/140509172919.htm (accessed October 20, 2014).

Share This



More Health & Medicine News

Monday, October 20, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Microneedle Patch Promises Painless Pricks

Microneedle Patch Promises Painless Pricks

Reuters - Innovations Video Online (Oct. 18, 2014) Researchers at The National University of Singapore have invented a new microneedle patch that could offer a faster and less painful delivery of drugs such as insulin and painkillers. Video provided by Reuters
Powered by NewsLook.com
Raw: Nurse Nina Pham Arrives in Maryland

Raw: Nurse Nina Pham Arrives in Maryland

AP (Oct. 17, 2014) The first nurse to be diagnosed with Ebola at a Dallas hospital walked down the stairs of an executive jet into an ambulance at an airport in Frederick, Maryland, on Thursday. Pham will be treated at the National Institutes of Health. (Oct. 16) Video provided by AP
Powered by NewsLook.com
Raw: Cruise Ship Returns to US Over Ebola Fears

Raw: Cruise Ship Returns to US Over Ebola Fears

AP (Oct. 17, 2014) A Caribbean cruise ship carrying a Dallas health care worker who is being monitored for signs of the Ebola virus is heading back to Texas, US, after being refused permission to dock in Cozumel, Mexico. (Oct. 17) Video provided by AP
Powered by NewsLook.com
Spanish Govt: Four Suspected Ebola Cases in Spain Test Negative

Spanish Govt: Four Suspected Ebola Cases in Spain Test Negative

AFP (Oct. 17, 2014) All four suspected Ebola cases admitted to hospitals in Spain on Thursday have tested negative for the deadly virus in a first round of tests, the government said Friday. Duration: 00:55 Video provided by AFP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins