With the realization that half of the people experiencing a sudden mortal heart attack were taking aspirin on the day of their demise, and the fact that higher-than-recommended doses of aspirin are needed to prevent blood clot formation in coronary arteries, coupled with an announcement that the red wine molecule resveratrol (rez-vair-ah-trawl) may protect from sudden mortal heart attack in a superior fashion to aspirin, suggests re-evaluation of cardiology's current instruction regarding prevention of heart attacks, says Nate Lebowitz MD, cardiologist with the Advanced Cardiology Institute in Ft. Lee, New Jersey.
In a presentation at a National Institutes of Health symposium in Washington DC today, University of Connecticut researchers showed resveratrol limits damage caused by a heart attack, prevents sudden cardiac death in animals, and is "the best yet devised method of cardioprotection."
This phenomenon is called "cardiac pre-conditioning" because it works to activate antioxidant defenses in the heart prior to a heart attack via the release of a chemical called adenosine.
"Being one of the few cardiology groups in the nation to have experience with both of these preventive agents, we are in a unique position to provide consultation to patients seeking answers to questions about the best ways to prevent fatal events," says Jacqueline Hollywood MD, another cardiologist with the Advanced Cardiology Institute.
Dr. Lebowitz says aspirin therapy for prevention of heart attacks has, in his experience, a limited effect. The greatest benefit of low-dose aspirin therapy is for women with a positive mutation of the apolipoprotein(a) gene (LPA gene), with diminished results for others, he says. This mutation is present in about 3% of Caucasians and higher in other subgroups.
A recent paper published in the American Journal of Medicine indicates the aspirin dosage recommended by the American College of Cardiology, the American Heart Association and the US Preventive Services Task Force (75-81 milligrams) appear to be far too low to produce a significant reduction in stroke or heart attack. The Food & Drug Administration first approved aspirin for secondary prevention of a heart attack in 1988.
Data shows that there will be ten times more patients who experience gastric bleeding from aspirin therapy than non-aspirin users, and no reduction in stroke or fatal heart attacks, when aspirin is taken in low doses.
James E. Dalen, MD, MPH, former dean of the University of Arizona College of Medicine, who wrote the review of aspirin therapy, says only one of seven human studies using 100 mg of aspirin show a decreased incidence of heart attack.