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Who should take aspirin for heart attack and stroke prevention?

Kathleen Blanchard's picture
A simple test could determine who would benefit from an aspirin a day for heart protection

Aspirin is an anti-inflammatory medication that can also help prevent heart attack and stroke. But the side effects can also be troublesome for some people and include risk of bleeding, gastric upset and ulcers. Who should take aspirin to prevent heart attack?

A better way to know when aspirin is good therapy

Researchers from the Minneapolis Heart Institute suggest there may be a better way to know which patients could benefit from taking aspirin for cardiovascular protection that comes from a retrospective study.

Researchers studied 4,229 participants in the Multi-Ethnic Study of Atherosclerosis (MESA) to determine people with higher levels of coronary artery calcium (CAC) are likely to benefit the most from aspirin therapy.

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A scan that measures the amount of calcium in the major blood vessels is easy to determine with a simple scan.

According to the study results, people whose CAC score is greater than 100 could be 2 to 4 times less likely to suffer stroke or heart attack if they are prescribed aspirin. For others who are not at high risk and whose score was zero, aspirin therapy could cause more harm that good.

Lead study author, Michael D Miedema, MD, MPH says until now it has been unclear whether people without known cardiovascular disease (CVD) should take aspirin. Prescribing the therapy only for people with known CVD could mean many others who would benefit from heart attack and stroke prevention could be missed.

"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," Miedema says.

The question of who should take aspirin to prevent stroke and heart attack requires more study. Results of the new analysis suggest a person's coronary artery calcium score that involves a simple test might help decide who can benefit from taking an aspirin a day.