Aspirin is not for everyone?

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I am sure you have heard that there are tons (OK, 60 million or so) of people taking aspirin every day to make sure they don’t get a heart attack. (No, I am not among them- I am allergic to aspirin.) The aspirin regimen exists because we know that aspirin makes platelets less “sticky”, less prone to clump together, which is what a blood clot is. (And, that means a stroke or a heart attack can be imminent.) But, up until recently, we did not know why some folks got heart attacks and others didn’t- even though they were both taking aspirin- some number less than 30% of those who take the pills are so affected. Until now.

Dr. Deepak Voora (Duke University), along with Drs. Cyr, Lucas, Chi, Dungan, McCaffrey, Katz, Newby, Strauss, Becker, Ortel, and Ginsbug, examined two groups of folks- those prone to heart attacks (i.e., they already manifested symptoms of  heart disease) that took baby aspirin (81 mg ) daily and others (healthy volunteers) who took 325 mg aspiring daily for at least a month. These results were published in the Journal of the American College of Cardiology.

Each subject was tested for their response to aspirin, and various genetic tests (RNA microarray profiling). It turns out that there are some 60 genes that seem to be related to the inability of aspirin to work the way one expects. (This was discerned via VerifyNow Aspirin testing or Platelet Function Score (PFS)). This study is a follow-on to the results that Voora, Ortel, Lucas, Chi, Becker, and Ginsberg reported for non-Cox-1 dependent platelet function.  The researchers termed the results the “aspirin response signature” (ARS); the folks who manifested ARS were at risk for myocardial infarction and/or death. Those undergoing cardiac catheterization with positive ARS exhibited a 30% increase in these adverse events- regardless of other risk factors, race, platelet count, etc.

Aspirin interferes with platelet aggregationIt should be further noted that the ARS phenomena was not observed, unless aspirin had been administered. As such, there is a latent effect these genes apply to platelet function, which is activated by the presence of aspirin. A provisional patent application has been submitted to the USPTO (US Patent and Trademark Office) to afford them the ability to market these results.

These results should let us better tailor our decision to prescribe aspirin regimens.

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17 thoughts on “Aspirin is not for everyone?”

    1. I never heard of aspirin for pregnancy, Melinda!
      I do agree that the FDA would probably give aspirin a hard time. And, it doesn’t help that we use it for so many different maladies (like pregancy)!

  1. Yeeesh – so many variable when it comes to meds. It certainly proves how different each of us may respond to the same medication – definitely not one size fits all!

  2. I hate this blanket recommendation that we should all take aspirin because, just like you, I am allergic to aspirin (it gives me terrible nose bleeds). I am glad that we are improving our understanding of how aspirin works. Interesting subject.

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