• Aspirin does not cut risk in non-obstruc

    From ScienceDaily@1:317/3 to All on Thursday, April 28, 2022 22:30:44
    Aspirin does not cut risk in non-obstructive coronary artery disease,
    study finds

    Date:
    April 28, 2022
    Source:
    Radiological Society of North America
    Summary:
    Aspirin therapy, as opposed to statin use, for non-obstructive
    coronary artery disease does not reduce major cardiovascular events,
    according to a new study.



    FULL STORY ========================================================================== Aspirin therapy, as opposed to statin use, for non-obstructive coronary
    artery disease does not reduce major cardiovascular events, according
    to a new study published in the journal Radiology: Cardiothoracic Imaging.


    ========================================================================== Coronary artery disease is the most common type of heart disease,
    affecting roughly 6.7% of U.S. adults, according to the Centers for
    Disease Control and Prevention. Coronary artery disease occurs when
    there is a buildup of plaque in the arteries that supply blood to the
    heart. Coronary artery disease puts people at a higher risk for major
    adverse cardiovascular events, including heart attack and death.

    Non-obstructive coronary artery disease occurs when there is less than 50% stenosis, or narrowing, of the coronary arteries due to plaque buildup.

    Coronary CT angiography (CCTA) is often recommended as a first-line test
    to detect plaque.

    Medications called statins are commonly prescribed for patients who
    are diagnosed with non-obstructive coronary artery disease. Statins
    reduce the production of low-density lipoprotein (LDL) cholesterol
    and draw cholesterol out of plaque, therefore stabilizing the plaque
    and reducing the risk of it rupturing. Aspirin is another drug that
    is commonly recommended. However, not much research has been done to
    determine whether aspirin is effective at reducing major cardiovascular
    events in patients with non-obstructive coronary artery disease.

    "While observational in nature, our data calls into question the value
    of initiating aspirin therapy following the diagnosis of non-obstructive coronary artery disease on a coronary CT angiography," said study author Jonathan Leipsic, M.D., professor and head of the Department of Radiology
    at the University of British Columbia in Vancouver, Canada.

    For the study, researchers used data from the CONFIRM (COronary
    CT Angiography EvaluatioN For Clinical Outcomes: An InteRnational
    Multicenter) registry, a large, multinational database of patients who
    have undergone CCTA. A total of 6,386 patients (mean age 56.0 years,
    52% men) who had either no detectable coronary plaque or non-obstructive coronary artery disease were selected.

    Patients with obstructive coronary artery disease that had 50% or greater stenosis were excluded. The mean follow-up period for selected patients
    was 5.7 years.

    A total of 3,571 (56%) of the patients included in the study
    had no plaque and 2,815 (44%) had non-obstructive coronary artery
    disease. Non-obstructive coronary artery disease was associated with a
    10.6% risk of all-cause mortality compared to 4.8% in patients without
    plaque.

    Baseline aspirin and statin use were documented for both groups. In
    individuals with nonobstructive coronary artery disease, aspirin therapy
    was not associated with a reduction in major adverse cardiovascular
    events. Alternatively, statin use was associated with a significant
    reduction in cardiovascular events, including heart attack and death.

    "Our findings build on prior analyses from the CONFIRM registry at
    2.3-year follow-up which called into question the utility of aspirin in
    the setting of CCTA diagnosed atherosclerosis," Dr. Leipsic said.

    Neither aspirin nor statin therapy improved clinical outcomes for patients
    with no detectable plaque. Aspirin therapy may still be beneficial in
    cases of high- risk plaque or high plaque burden, Dr. Leipsic said.

    "Ultimately, further research is required to determine whether, and
    at what threshold, clinicians should consider prescribing aspirin for
    patients upon the identification of non-obstructive coronary artery
    disease on coronary CT angiography," he said.


    ========================================================================== Story Source: Materials provided by
    Radiological_Society_of_North_America. Note: Content may be edited for
    style and length.


    ========================================================================== Journal References:
    1. Praveen Indraratna, Christopher Naoum, Sagit Ben Zekry, Heidi
    Gransar,
    Philipp Blanke, Stephanie Sellers, Stephan Achenbach, Mouaz
    H. Al-Mallah, Daniele Andreini, Daniel S. Berman, Matthew J. Budoff,
    Filippo Cademartiri, Tracy Q. Callister, Hyuk-Jae Chang, Kavitha
    Chinnaiyan, Benjamin J. W. Chow, Ricardo C. Cury, Augustin DeLago,
    Gudrun Feuchtner, Martin Hadamitzky, Joerg Hausleiter, Philipp
    A. Kaufmann, Yong‐Jin Kim, Erica Maffei, Hugo Marques,
    Pedro de Arau'jo Gonc,alves, Gianluca Pontone, Gilbert L. Raff,
    Ronen Rubinshtein, Todd C. Villines, Fay Y.

    Lin, Leslee J. Shaw, Jagat Narula, Jeroen J. Bax, Jonathon
    A. Leipsic.

    Aspirin and Statin Therapy for Nonobstructive Coronary Artery
    Disease: Five-year Outcomes from the CONFIRM Registry. Radiology:
    Cardiothoracic Imaging, 2022; 4 (2) DOI: 10.1148/ryct.210225
    2. Arzu Canan, Ann Marie Navar. Limitations of Observational Studies
    for
    Aspirin in Primary Prevention and the Need for Randomized Trials.

    Radiology: Cardiothoracic Imaging, 2022; 4 (2) DOI:
    10.1148/ryct.220079 ==========================================================================

    Link to news story: https://www.sciencedaily.com/releases/2022/04/220428103941.htm

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