THE ESSENTIAL
- To diagnose coronary heart disease, the patient must do several tests: electrocardiogram, blood test and, sometimes, coronary angiography.
- In case of coronary pathology, the treatment will be prescribed by an attending physician and a cardiologist.
On average, there are 80,000 myocardial infarctions in France per year according to theNational Institute of Health and Medical Research (Inserm). This is one of the risks associated with coronary heart disease, that is to say all the pathologies that are triggered when the blood supply to the heart muscle is interrupted or blocked.
The formation of plaques in the arteries
This is usually due to obstruction of the coronary arteries by an accumulation of fat, also known as bad cholesterol. These accumulated fats form plaques that narrow the arteries and harden them. As time goes by, the blood circulates less and less well.
The effectiveness of aspirin questioned…
When coronary artery disease is diagnosed, doctors usually prescribe two types of treatment: statins or aspirin. The first reduces the production and presence of bad cholesterol in the patient’s body. In a study published in the journal Radiology Cardiothoracic Imagingresearchers have doubts regarding the effectiveness of the second treatment, aspirin.
…for the management of coronary artery disease
“Our data call into question the appropriateness of treatment with aspirin following diagnosis of non-obstructive coronary artery disease made from coronary angiography (a medical imaging technique that creates images of blood vessels)”, explains Jonathan Leipsic, one of the authors of the study.
A study on more than 6300 patients
To carry out their work, the researchers analyzed the health data – collected over more than 5 years – of approximately 6,300 patients who had undergone coronary angiography. 52% of them were men and the average age was 56 years old.
Two groups studied
Participants were divided into two groups: the first with 56% of patients – more than 3,500 people – who had no detectable coronary plaque. And the second, with 44% of patients, or 2,815 participants, who had non-obstructive coronary artery disease.
In parallel, the researchers estimated that patients who had no plaque (the first group), had a 4.8% increased risk of mortality from all causes combined. In those with non-obstructive coronary artery disease, this percentage was 10.6%.
Aspirin does not reduce cardiovascular risk
In both groups, the researchers wanted to study the impact of aspirin and statin. In the first, where patients had no detectable plaques, neither aspirin nor statins reduced cardiovascular risk.
On the other hand, in the second group comprising patients with non-obstructive coronary artery disease, aspirin did not show any efficacy but the use of statins did allow a significant reduction in cardiovascular risks, including heart attacks and the death.
continue research
“Further research is needed to determine whether – and at what threshold – physicians should consider prescribing aspirin to patients upon identification of non-obstructive coronary artery disease detected by coronary angiography.“, concludes Jonathan Leipsic.
