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Item #15
Aspirin's
Anti-Clotting Ineffective for those at Greatest Risk
Some
people are resistant to the drug' anti-clotting effect, and they may
have a threefold higher risk of death, heart attack or stroke.
Millions
of Americans rely on an aspirin a day to help keep heart attacks and
strokes away. But a new study in the Journal of the American College
of Cardiology shows that it doesn’t for everyone.
Dr.
Eric Topol of the Cleveland Clinic Foundation stated that,
"Probably there has been no medicine that has had a greater
impact in our field than aspirin, but we took for granted that it
worked in everyone,"
"We
have to increasingly appreciate that aspirin resistance is real and
not turn our backs on it," he said. "And we need to hunt
this thing down: the cause, the specific ways to more rapidly screen
for it, find its genetic basis -- which is only a theory at the moment
-- and protect these patients. They are taking aspirin, but they are
not deriving benefit from it. So there are a lot of people out there
who have the illusion of being protected by aspirin."
The
researchers enrolled 326 patients between January 1997 and September
1999 who had a history of cardiovascular disease but were stable at
the time they joined the study. Based on blood tests performed after
each patient had been taking 325 mg of aspirin for at least a week, 17
patients (5.2 percent) were found to be resistant to the anti-clotting
effect of aspirin. (Typical aspirin therapy uses 81 mg or 162 mg of
aspirin daily.)
During
an average follow-up period of almost two years, aspirin-resistant
patients were more than three times as likely to die or suffer a heart
attack or stroke.
If
aspirin resistance is related to a genetic mutation, an inexpensive
genetic screening test might be possible, but first researchers would
need to find the right gene.
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