Non-obstructive coronary artery disease occurs when there is less than 50% stenosis, or narrowing, of the coronary arteries due to plaque buildup. Coronary CT angiography (CCTA) is often recommended as the first-line test for plaque detection.
Statin drugs are often prescribed for patients diagnosed with non-obstructive coronary artery disease. Statins reduce low-density lipoprotein (LDL) cholesterol production and draw cholesterol out of plaque, thereby stabilizing the plaque and reducing the risk of it breaking. Aspirin is another commonly recommended medication. However, not many studies have been performed to determine whether aspirin is effective in reducing major cardiovascular events in patients with non-obstructive coronary artery disease.
Study author Jonathan Leipsic, MD, professor and chair of the department of radiology, said: “Although observational, our data call into question the value of starting aspirin therapy after Diagnosis of nonobstructive coronary artery disease on coronary CT angiography. at the University of British Columbia in Vancouver, Canada.
Aspirin for heart disease
For the study, the researchers used data from the CONFIRM (COronary CT Angiography EvaluatioN For Clinical Out Results: An InteRnational Multicenter) registry, a large, multinational database of patients who had undergone medical treatment. via CCTA. A total of 6,386 patients (mean age 56.0 years, 52% men) with no detectable coronary plaque or non-obstructive coronary artery disease were selected. Patients with obstructive coronary artery disease with stenosis of 50% or more were excluded. The median follow-up for the selected patients was 5.7 years.
A total of 3,571 (56%) patients in the study had no plaque and 2,815 (44%) had non-obstructive coronary artery disease. Non-obstructive coronary artery disease was associated with 10.6% risk of all-cause mortality compared with 4.8% in patients without atherosclerotic plaque.
Initial use of aspirin and statins was noted for both groups. In addition, statin use is associated with a significant reduction in cardiovascular events, including heart attack and death.
Dr Leipsic said: “Our findings build on previous analyzes from the CONFIRM registry at 2.3 years.
Neither aspirin nor statin therapy improved clinical outcomes for patients with no detectable plaque. Dr. Leipsic said aspirin therapy can still be beneficial in cases where there is a lot of high-risk plaque or high-grade plaque.
“Ultimately, further studies are needed to determine whether clinicians should consider prescribing aspirin to patients when identifying nonobstructive coronary artery disease on CT angiography,” he said. .