By Jeffrey Kopman
An aspirin a day might keep your heart attacks at bay, researchers say, and there could be a blood test that lets you know for sure — even before you start aspirin therapy, according to a study from the Duke University Medical Center, published in the Journal of the American College of Cardiology.
"Nearly 60 million people take aspirin regularly to reduce their chances of heart attack and death, but it doesn't work for everyone," said Rochelle Long, Ph.D., of the National Institutes of Health's National Institute of General Medical Sciences, which partly supported the study, in a press release.
Researchers felt that identifying which patients should, and should not, be placed on aspirin therapy could be useful information for millions of people. The highly popular heart attack prevention treatment is considered low-risk, but can still cause some serious side effects – like internal bleeding and stomach problems.
The study authors recruited 128 volunteers who were then assigned to three groups: two groups of healthy volunteers and one of patients with heart disease. A series of tests led researchers to identify a set of 60 genes that they named the “aspirin response signature.”
These platelet-specific genes proved to not only identify patients who are likely to benefit from aspirin therapy, but also patients who are at risk for heart attack. These findings were consistent for all patient groups studied.
"The aspirin response signature can determine who is at risk for heart attack and death," said Deepak Voora, M.D., assistant professor of medicine at Duke and lead author of the study, in a press release. "There is something about the biology of platelets that determines how well we respond to aspirin, and we can now capture that with a genomic signature in blood."
Researchers hope this biomarker discovery will lead to development of a blood test that can better identify patients who will or will not benefit from aspirin therapy.
Choosing Aspirin Therapy
Aspirin therapy can be extremely beneficial for patients with a history of heart disease, but it is often over prescribed, some experts believe.
“Because aspirin is cheap and safe, it’s widely prescribed,” said William O’Neill, MD, of the Center for Structural Heart Disease, Henry Ford Hospital in Detroit, who was not affiliated with the study.
Dr. O’Neill admitted there are few risks associated with the treatment, but he does not recommend it for everyone.
“Two types of people that should try [aspirin therapy] are people who have had a stent inserted and already had heart disease, and people who are recovering from a heart attack,” he said. “There is a ton of information showing it can prevent a second heart attack.”
However, O’Neill did say some people should avoid the therapy.
“If people have had a history of bleeding in the stomach they shouldn’t go on it,” he said. “Aspirin can cause serious problems like bleeding and gastritis of the stomach. If you’re asymptomatic you shouldn’t need to be on the therapy.”
O’Neill conceded that, for many patients, it’s tough to tell who will benefit and who will not.
“It’s very helpful for secondary prevention of heart attacks, but not quite for primary,” he explained. “A biomarker will help us figure out if people in that gray zone should go on aspirin therapy.”
"Blood Test Could Give You the 'Okay' for an Aspirin a Day" originally appeared on Everyday Health.