June 30, 2010

Could You Be Resistant To Aspirin or Plavix?

Posted in Heart disease tips, New Heart Studies, Uncategorized tagged , , , , , , , , at 12:53 am by keepyourhearthealthy

Sometimes heart disease patients can do all the right things and yet still have another heart attack soon after being diagnosed.  They may be taking their medicines faithfully, exercising daily and eating right.  When a second heart attack comes so soon despite all attempts to prevent it, the patient is left to wonder “What went wrong?”

The process of prevention is not a perfect one by any means.  The American Heart Association has stated that a particular combination of medicines prescribed by cardiologists could reduce the chance of heart disease deaths by 80% compared to placebo.  But within the last 2 years more studies have shown that a select group of patients receive less benefit from the standard therapies.  It turns out that some people are resistant to two of the most important heart disease medications: aspirin and Plavix.  A study in 2008 suggested that as many as 28% of patients are resistant to aspirin.  Scientists have also identified a specific genetic marker that indicates a person who will not respond to Plavix therapy.  Aspirin and Plavix are used in many heart disease patients as a means of preventing clots that form during a heart attack.  If some patients are resistant to these two drugs then they have a higher risk of heart attack, stroke and death.

Ever since the medical community began discussing the phenomena of aspirin and Plavix resistance, possible solutions have been recommended.  First, a good set of tests are needed to identify these patients.  Currently there is no standard test for aspirin resistance that is accepted throughout the medical community.  A new blood test is however available to check for Plavix resistance (the P2Y12 assay).  Unfortunately this blood test is not a common enough test in many areas of the country.  The lack of testing available for resistance is a huge obstacle that scientists have yet to tackle.

Even if a cardiologist suspects or confirms that a patient is resistant, there are no guidelines to outline what should be done next.  In some cases, higher doses of aspirin or Plavix are given.  So, if someone was previously on 81mg of aspirin their doctor might increase the dose to 325mg.  For patients resistant to Plavix an alternative drug called Effient may be prescribed in lieu of increasing the dosage.  Without appropriate studies to backup the treatment options it’s difficult for anyone to say the best course of action.

On the bright side, a new study was just published in April that shows there is a benefit in adding Omega-3 fatty acids for people who are Plavix resistant.  Omega-3 fatty acids are available over the counter as Fish Oil and are well known as a mild “blood thinner.”  Could Fish Oil be a possible solution for the aspirin and Plavix resistant population?  Hopefully we will find out soon!  In the meantime, everyone should continue to take aspirin and Plavix/Effient if prescribed by their cardiologist.  If you want to be as proactive as possible, you always have the option of adding Fish Oil to your daily medications if cleared by your doctor.

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