Aspirin Resistance

May 8, 2008 8:53:26 PM PDT
Millions of Americans take a tablet each day thinking it will help prevent heart attacks. But it may be a waste of time for some people.

There's never a guarantee that a medication will work for everyone. But, aspirin has become a big part of the treatment and prevention of heart disease. So it may be surprising that even though there are ways to detect aspirin resistance, many doctors don't.

Every day, millions of people across the globe pop an aspirin for protection.

"I just took aspirin because my doctor told me to and I just figured it worked," said Tracey Powell, patient.

There is study after scientific study showing aspirin has the power to protect against cardiovascular disease and stroke.

Aspirin helps thin the blood, preventing sticky fragments called platelets from bunching together, blocking arteries and causing heart attacks or stroke.

But for Kulbir Tukral an aspirin a day may not have been working. He had his first heart attack at 44 and despite years of intensive therapy, his heart problems persisted.

His cardiologist decided to test his blood and discovered his platelets were not acting right.

"I went, 'Ah ha,. he is not responding properly to the drugs. We're on to something,'" said Dr. Mike Salinger, Interventional Cardiologist, Evanston Hospital.

Salinger said he believes for some people aspirin may have a hard time doing it's job. So why not screen all patients?

"While it seems straightforward, it really isn't. This is a very complicated subject. It's potentially a very important subject," Salinger said.

Many doctors say there are critical questions that remain unresolved. That's precisely why many medical centers like the University of Illinois at Chicago are not routinely testing patients.

"How do you define it? How do you measure it? How do you treat it?" asked Dr. John Kao, Interventional Cardiologist, U of I Medical Center at Chicago.

There are conflicting studies on the number of patients who do not respond to aspirin and the range is said to be anywhere from five to a whopping 60 percent. Adding to the confusion: there's no standard way to screen for this. Several tests are available. But accuracy is a concern.

Edward Hospital is now using an updated test called Aspirin Works. It measures a bi product in urine. Some believe it will prove to be more dependable.

"So why wouldn't you want to know where you stand in all of this?" wondered Larry Brace, Ph.D., lab director, Edward Hospital.

Brace says he's been studying aspirin resistance for years. He said he thinks the science is sound and balks at critics who claim this issue is being hyped by companies pushing these tests. Brace says the bottom line is non responders usually will not be harmed by the drug. But their resistance could be sending doctors a warning sign of bigger problems. Research shows they are at greater risk of dying from a heart attack or stroke.

"Aspirin resistance is bad news for patients who are taking aspirin and they need to know that," Brace said.

But, there is no easy fix. Doctors may prescribe higher doses of aspirin or additional anit-clotting medication. That's the game plan for Kulbir. He's also keeping a close eye on his diet and exercise.

"So far things seem to be OK, considering my normal state," he said.

The reasons people may be resistant to aspirin are still a mystery. It may have something to do with metabolism or genetics. For some people, it's simply the fact that they are not taking their aspirin regularly. As for the cost of the various tests, they run between $35 and $125. And doctors say to really clear up all the confusion, the federal government needs to fund a rigorous, scientific study on the issue.

Corgenix AspirinWorks test 800.729.5661 x180 or 303.457.4345 x180 11575 Main Street, Suite 400, Broomfield, CO. 80020 USA www.corgenixonline.com www.aspirinworks.com

Dr. Mike Salinger Evanston Northwestern Healthcare 847-570-2250 www.enh.org

Dr. John A. Kao University of Illinois at Chicago 312-996-1683 www.uic.edu

Larry Brace, Ph.D. Laboratory & Pathology Diagnostics Edward Hospital 630-527-5676 www.labpathdx.com

VerifyNow Accumetrics 3985 Sorrento Valley Boulevard San Diego, California 92121 Toll Free: 800.643.1640 www.accumetrics.com

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