The US Cardiovascular Arena-In Brief A Round-up of Trends, Statistics, and Clinical Research

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US Cardiology, 2007;4(1):12-3


Doctors Proactive in Pre-diagnosis Treatment of Heart Attacks

Doctors are treating patients with a suspected heart attack as aggressively as they are patients who have been diagnosed with an attack. Researchers from Wake Forest University School of Medicine analyzed patient data from over 450 hospitals in 12 countries. They compared the treatment received by patients with different levels of troponin—a protein and a marker of damage to the heart muscle—in their initial evaluation after arriving at hospital.
Troponin levels become elevated over a six- to eight-hour period after the occurrence of a heart attack, making a definite diagnosis problematic in the first few hours following an attack. The study aimed to determine whether the resulting delay in diagnosis can impact on patient care. Patients were divided into three groups: those who presented with elevated troponin levels and were therefore known to have had a heart attack, those whose troponin levels became elevated within 12 hours, and those who showed no elevation. The results showed that for the first two groups, which can be classified as high-risk, treatment options were very similar. Both groups were initially treated with blood-thinning agents such as aspirin and received similar levels of invasive treatment such as angioplasty and bypass surgery.
The finding is encouraging, as it suggests that doctors are being proactive in their treatment decisions, with patients receiving vital treatment even before the presence of a heart attack is confirmed through laboratory tests. Ôûá

Aspirin Less Effective Therapy for Women

Women who take aspirin daily to reduce the risk of heart attack or stroke may not be benefiting from the therapy at all. Researchers from the University of Michigan College of Pharmacy have found that women are more resistant to aspirin, regardless of their medical history.
Aspirin is taken regularly by approximately 20 million people and is thought to cut the probability of a non-fatal heart attack or stroke by around one-fifth. It works by suppressing the tendency of platelets in the blood to clump together to form blood clots. Previous studies had indicated aspirin therapy to be less effective for women, but did not indicate why. Furthermore, previous studies on aspirin resistance were carried out in patients with a history of heart attacks. The present study involved 100 patients with stable coronary heart disease, half of whom had experienced a heart attack in the past. Blood samples taken from the patients were exposed to a blood-clotting agent, and platelet activity was analyzed using the VerifyNow Aspirin Assay device. Platelet inhibition of 40% or more is taken as a mark of aspirin resistance.