Asprin, why?

[Agian]

Maybe I'm missing something important, but what I think it's saying is that people with calcification are more likely to be using Aspirin, or a statin. I guess it's like saying high blood pressure is associated with the use of antihypertensives.

"We examined the association of coronary artery calcium (CAC) detected on a screening exam with subsequent statin and aspirin usage in a healthy male screening cohort."

What do other people think?

 

[pellicle]

Aspirin does not thin blood.
It acts as an anti-coagulant ....

Correct, the same is true for warfarin. Neither effect the viscosity (thickness or thinness ).of blood.

Bugs me that the term thinners is used as it leads to all manner of misconceptions.
Still, what else to say that isn't a mouth full?

 

[pellicle]

ad an AVR about 4 months ago with a Bovine valve. I currently take a daily 81mg aspirin, but am thinking about stopping it. My Cardiologist said that basically everyone should take a daily Aspirin for cardio-protection. I don't think that argument is compelling enough.

So, you have some other studies suggesting otherwise?

I saw this study about people who took Asprin having a greater likelihood of coronary calcifications. I imagine that since Aspirin makes the blood more "slippery", that it doesn't quite "wash" the calcium off the sides of arteries etc. Since I want to minimize the risk of my valve calcifying in the future, I imagine it would be a good idea to stop the Aspirin, especially since I don't really need it.

Be cautious in using simplifications (created to explain a problem to a layman) as a basis for extrapolation. Bound to cause problems.

Illustrative models serve a purpose, usually analysis is not one of them.

Here is the highlight from the study and link below. Any comments are appreciated!

"The presence of coronary calcification was associated with an independent 3-fold greater likelihood of statin and aspirin usage and more appropriate use of statins during 6-year follow-up within the PACC Project cohort. These findings support the concept that the identification of coronary calcium in a screening population leads to shifts in clinical patient management reflected in the provision of preventive cardiovascular pharmacotherapies."

http://content.onlinejacc.org/article.aspx?articleid=1138796&issueno=14

Immediately this is complicated by inclusion of Statin. Are you taking any statins?

A quick search seems to suggest the opposite effect of aspirin with the anticoagulant heparin:

Calcification is a frequent cause of the clinical failure of bioprosthetic heart valves fabricated from glutaraldehyde pretreated bovine pericardium (GATBP). Aspirin, a potent antiplatelet drug, and heparin, an anticoagulant, are commonly used for postimplant complications such as thrombosis and thromboembolism. Aspirin and heparin were embedded in chitosan/polyethylene vinylacetate co-matrix to develop a prolonged release form. The effect of these drugs towards the bioprosthetic calcification was investigated by in vitro and in vivo models. In vitro and in vivo evaluation suggest that the released aspirin/heparin from the co-matrix had a synergistic effect in inhibiting GATBP calcification. In vivo subcutaneous co-implantation was performed with PEG-20,000 grafted bovine pericardium (PEG-GABP), aspirin, and heparin. Biochemical, histological, and scanning electron microscopic evaluation of retrieved samples demonstrated a significant reduction in calcium deposition and alkaline phosphatase activity on PEG-GABP compared to GATBP.It seems that the aspirin/heparin combination synergistically inhibits the pericardial calcification in addition to their antithrombotic function.

http://www.ncbi.nlm.nih.gov/m/pubmed/10718766/

 

[Agian]

What I think the study is saying is that patients who have been found to have calcification are likely to subsequently be prescribed aspirin and statins (hence the association). Bunions may be associated with seeing a podiatrist; but this does not mean that podiatrists cause bunions.

"These findings support the concept that the identification of coronary calcium in a screening population leads to shifts in clinical patient management reflected in the provision of preventive cardiovascular pharmacotherapies."

 

[pellicle]

What I think the study is saying is that patients who have been found to have calcification are likely to subsequently be prescribed aspirin and statins (hence the association). Bunions may be associated with seeing a podiatrist; but this does not mean that podiatrists cause bunions.

I agree. I don't think that the article is suggesting causality either (now that I've read it carefully).

 

[neo]

Asprin, why?

I appreciate all of your thorough responses. You all make a great point that these people probably already had coronary disease before they were prescribed the aspirin and statins.

This reminds me of another study that has been making news lately. In sure you all have heard about the study linking Omega 3s to prostate cancer. It also appears as though these patients were surely given fish oil supplements, or encouraged to eat a better diet, after their diagnosis rather than before.

Thanks again.

 

[Agian]

I stopped fish oil for a while, because of the prostrate cancer thing. I'm back on it now. There was also some palava about listerine causing mouth cancer. I'm not convinced, but I'm using a chlorhexidine mouthwash (it's called curasept).

 

[Gail in Ca]

My first surgeon in 1989 told me that he would recommend all adults take a baby aspirin every other day at that time.
I think daily is what they seem to think is good now.
I take 81 mg AM and my warfarin after dinner. As far as INR range, those of us that have the newer aortic mechanical are told 2-2.5 is fine, even down to 1.8 is OK.
After many months of 2-2.5, I increased mine to 2-3.0. I try to keep it at 2.5, but if it drops to 2.0 I don't worry. I let it go another week, test again and it's always been in range. I thought our machines had only a .2 error rate, and that they might read, say, 1.8, but the error rate might make it really 2.0, not 1.6.
I'm sure the cardio has a reason to start you on aspirin therapy. They may stop it before surgery, as they stop warfarin.