Heart Disease Prevention - SCAD A Typical Heart Attack Striking Mostly Females

Unlike a more typical heart attack caused by a buildup of plaque in the arteries, a SCAD heart attack starts with a tear in an artery. The tear blocks the artery and blood flow to the heart, leading to a heart attack. Victims of SCAD are often thin, appear heathy, and have no risk factors like smoking and diabetes. More at:

Heart Disease Prevention - SCAD A Typical Heart Attack Striking Mostly Females

Is Aspirin Safe?

Being a blood thinner, aspirin suppresses clotting that might lead to heart attack and ischemic stroke (caused by a blocked artery in the brain). Some studies already have shown that taking doses ranging from an 81-milligram baby aspirin to a 325-milligram full-strength tablet can be helpful and aspirin therapy is recommended for those who have had a heart attack or who are at high risk for one. 

Taking aspirin can also raise the risk of dangerous bleeding in the stomach or brain. In a group of people with existing cardiovascular disease, aspirin can prevent 250 cardiovascular events such as heart attacks, strokes, and sudden death. At the same time, 40 cases of serious bleeding will occur. The ratio of risk to benefit is roughly 6 people benefited for every one harmed. But as a public health policy, this risk equation is considered to be acceptable.

Hence, people who already have had a heart attack, ischemic stroke or other diagnosed cardiovascular disease that places them at higher risk of additional problems should take low-dose aspirin as advised by their doctors, unless they have some major bleeding issues or an allergy.

Meanwhile, millions of Americans are taking aspirin everyday for primary prevention of cardiovascular disease because it is cheap and widely available. Primary prevention means one does not have cardiovascular disease but hope that aspirin would help prevent it.

In reality, aspirin might not suitable for everyone. A study, which was published on June 6, 2012 in ‘Journal of the American Medical Association’, found that 20 out of every 10,000 people experienced a major bleed – 5 times higher than the bleeding rate seen in previous clinical trials, after examining health records of nearly 40,000 people in the Italian National Health Service.

On May 6, 2014, the Federal Food and Drug Administration (FDA) issued a reminder indicating that while taking an aspirin a day might help prevent heart attack or stroke in some people, it might not be appropriate for everyone because the common drug can have serious side effects that offset the benefits. Hence, it should only be used only for people at high risk of heart attack and stroke under the care of their doctors.

Also, FDA has finally told giant drug maker Bayer Corp not to expect FDA to approve for labels listing aspirin as a drug for primary prevention of heart attack and stroke since studies had so far not been able to show a significant benefit of aspirin for primary prevention uses.

But people who are already on aspirin prescribed by their doctors should not stop taking it without checking with their doctors since it can be life-threatening to abruptly halt their doses.

What Can Plavix and Aspirin Do For Heart Disease Patients With AF?

A blood thinner, a common name for an anticoagulant agent, is a drug used to prevent formation of blood clots by hindering coagula. Blood thinner does not really thin the blood; it just prevents the blood from clotting. Doctors usually prescribe blood thinners to heart disease patients who are at risk for heart attack and stroke.

So far, anticoagulants such as warfarin and aspirin have been the only effective therapies in treating heart disease patients suffering from atrial fibrillation (AF). AF is a condition in which the heart's 2 upper chambers, the atria, quiver instead of beating effectively. This will raise the risk of blood clotting or pooling in the chambers that could eventually trigger a heart attack or stroke.

According to the American Heart Association (AHA), there are some 2.2 million Americans suffer from AF. These patients often need to be fitted with a pacemaker. Yet many of them cannot be treated with warfarin to stop blood clotting because warfarin increases the risk of an internal hemorrhage by up to 70 percent.

At the annual conference of the American College of Cardiology in Orlando on March 31, 2009, researchers from Ontario's McMaster University revealed that they managed to help AF patients cut the risk of heart attack and stroke by combining Plavix with aspirin.

Plavix is known under the generic name of clopidogrel. It is used to prevent the platelets in blood from coagulating and forming clots.

ACTIVE-A, a clinical trials involving 7,554 patients, aimed to determine whether the addition of clopidogrel to aspirin could reduce major vascular events and stroke in AF patients at an acceptable risk of increased hemorrhage. In the trials, the researchers showed that combination of Plavix and aspirin could help AF patients who are unable to take other blood thinners like warfarin.

The combination of clopidogrel and aspirin reduced major vascular events by 11 percent, including a 28 percent reduction in stroke and a 23 percent reduction in myocardial infarction (also known as heart attack), as found in the study.

It is believed that this is a new treatment for AF for the first time in 20 years.

Can Fish Oil Benefit Heart?

Omega-3 fatty acids can be found in such wild oily fish as salmon, tuna, mackerel, sardines and herring. It is believed that omega-3 fatty acids could benefit heart as it could raise HDL (high-density lipoprotein) or good cholesterol, lowers harmful fats known as triglycerides and slow the growth of plaque that tend to clog arteries.

According to the recommendation by the American Heart Association, adults should take fish at least twice a week, and people with heart disease should consume 1 gram of omega-3 fatty acid a day.

However, a recent large study conducted in Germany seemed to get a rather surprising finding. Researchers from the University of Heidelberg reported that fish oil capsules did not offer added benefit to heart attack patients who are already taking the right medications to prevent future problems. Their results were presented on March 30, 2009 at an American College of Cardiology conference.

In the study, more than 3,800 people who had suffered a heart attack in the previous 2 weeks were given 1-gram daily dose of a prescription version of highly purified omega-3 fatty acid or dummy capsules. About 90 percent of these people were already receiving all the necessary medications prescribed by their doctors to prevent a second attack, including aspirin, anti-clotting and cholesterol drugs.

The prescription version used in the study is a highly purified and standardized form, and is different from what many consumers buy off the shelf. They are sold as Omacor and Lovaza in the United States and as Zodin in Europe,

After a year, the researchers found no difference in both groups of patients, whether they took fish oil or dummy capsules. The researchers also found that 2 percent had suffered sudden cardiac death, 4 percent had another heart attack and fewer than 2 percent had suffered a stroke in both groups of patients.

The researchers argued that there is nothing much can be done to further reduce the risk for heart attack patients, who have already received good care from their doctors (given all necessary medications). Nevertheless, this does not mean that fish oil is of no value. In the first place, the study did not address whether fish oil could help prevent heart disease.

Drugs Combination Could Raise The Risk of Another Heart Attack!

It is common practice for doctors to prescribe blood-thinning medication such as Plavix or aspirin together with a proton pump inhibitor (PPI) like Prilosec to their patients who had heart attack.

Plavix is also known as clopidogrel, and is manufactured by Sanofi-Aventis SA and Bristol-Myers Squibb Co. On the other hand, Prilosec is a drug for heartburn and is product of AstraZeneca Plc. The purpose of taking PPI is to cut the risk of gastrointestinal bleeding from blood thinners.

However, the latest research showed that people who suffer a heart attack will nearly double their chance of getting another if they are taking Plavix together with a heartburn drug.

A study conducted by researchers from the Denver VA Medical Center indicated that two-thirds of the heart attack patients who took Plavix and aspirin together with a PPI, primarily Prilosec, had almost double the risk of having another heart attack or bout of unstable angina, comparing with those not taking a PPI. Their findings were published on March 3, 2009 in the Journal of the American Medical Association.

In the study, the researchers tracked some 8,205 United States patients, who were treated for a heart attack or chest pain known as unstable angina, and who were given Plavix and aspirin. The study highlighted a potential interaction between clopidogrel and PPI medication, and the researchers believed that this drug combination might be responsible for thousands of repeat heart attacks.

Therefore, they suggested that PPI medication should not just be prescribed routinely or prophylactically in patients who are on aspirin and clopidogrel.

Nevertheless, the findings have not been widely accepted among medical circles and some doctors actually express their worries. If PPIs are not prescribed for heart attack patients, it is possible that more bleeding complications would occur among the patients. It is undeniably that a big bleed for a patient with significant coronary artery disease could be fatal.

As such, some doctors urged caution regarding the findings. Perhaps, more studies should be carried out to strengthen the findings and better still to look for alternative ways of treatment.

Can Watching Football Match Really Lead to Heart Attack?

During the 2006 World Cup, researchers at the Munich University Clinic in southern Germany found that cardiac arrests and palpitations among men in the greater Munich area were more than tripled compared to the same period over 3 preceding areas. For women, the rate was double.

The researchers also found that “the more important the game, the greater the risk”. The number of heart attack cases actually surged when Germany played in the quarterfinals against Argentina (Germany won), and in the semifinal against Italy (Germany lost). Both games were decided after extra time and penalty shootout, which has already been found as a risk by previous research.

As the figures are so alarming, some experts urge patients with potential risk to take stress-receptor blockers, aspirin and statins, or even consider behavior therapy to calm them down before sitting down the soda to watch the football matches. The health experts even advise those patients who had a heart attack or who are considered to have a high cardiac risk to avoid watching important matches.

In fact, researchers at the University of Birmingham, in central England, already discovered that the number of heart attacks in Britain rose by 25 percent on the day England lost to Argentina on kicks in the 1998 World Cup. As such, they had suggested that penalty shootouts should be scrapped “on public health grounds”.

Then, there are the longer-term health problems for the football fans: they tended to develop into couch-potato lifestyle: non-stop boozing and snacking on starchy, fatty, salty or sweet foods. Such unhealthy lifestyle is partly responsible for major health problems like obesity, diabetes and heart disease found in Europe. Some health experts even blame the match organizations for advertising unhealthy products. They believe such act will do no good for the public health, and instead help the football spectators cultivate their unhealthy lifestyle.

Besides cardiac arrests, the reported number of emergency calls, wife beatings, depression, drunken driving, self-harm and even suicide is rising during major football sessions.

Can you imagine, a football fan would eventually be led to such a disaster by just watching football matches!

Aspirin May Not Be Effective For Women In Lowering Risk Of Heart Attack

Aspirin therapy has widely been used to prevent heart attacks for both men and women. But there may be considerable variation between men and women in the effectiveness of aspirin therapy in reducing the risk of heart attacks.

A recent study, conducted by a group of researchers from University of British Columbia, Vancouver and published online in BMC Medicine, indicated that women may be much less responsive to aspirin than men.

By identifying 23 clinical trials, the researchers examined the effectiveness of aspirin therapy in preventing heart attacks for a total of 113,494 participants. The researchers reported that aspirin therapy, when compared to placebo, provided a modest reduction in the risk of non-fatal heart attacks (28 percent), but did not reduce the risk of fatal heart attacks.

However, considerable variation in the effectiveness of aspirin across the trials was noted. It was found that roughly 27 per cent of the total variation in reports of non-fatal heart attacks could actually be explained by the proportion of men and women in the trial.

According to what the researchers had found, studies that included men had the largest risk reduction in non-fatal heart attacks (38 percent), while trials that mostly included women failed to show a significant reduction in the risk of non-fatal heart attack.

Based on the data analyzed, the researchers concluded that aspirin is less efficacious in women for the reduction of heart attacks. They also raised the possibility that women are more susceptible to aspirin resistance.

Is Aspirin That Important?

Surveys in the US and UK have shown that less than half of patients with high-risk conditions are prescribed aspirin. The researchers estimate that world wide 40,000 extra lives could be saved every year with 3,000 lives saved along in the UK, if every one with high-risk condition for whom aspirin was appropriate actually received it.

When used for secondary prevention, the benefit from aspirin readily outweighs possible harm from major haemorrhage (bleeding). In addition, the new study found that lower daily doses of aspirin (75-150mg) are as effective as higher doses for longer time.

In conclusion, aspirin is protective in most type of patients at increased risk of cardiovascular events, including those with myocardial infarction, ischemic stroke, unstable/stable angina, previous myocardial infarction, stroke, cerebral ischemia, peripheral artery disease or atrial fibrillation.