By Rashmi Vaish
“Patients think an Aspirin a day will keep the doctor away,” said Dr. Guy Mintz, Medical Director of the New York Preventive Cardiology Institute at 78-01 Myrtle Ave. in Glendale. “But that's not always true because some people do have heart attacks and strokes despite being on aspirin.”
The concept of Aspirin resistance is not all that new, he said. “We could identify Aspirin resistance, but only through a very tedious test at a large tertiary care hospital.”
That has changed in last year or so. A new FDA approved test, VerifyNow developed by a company called Accumetrics, is now available to physicians to be used in their offices itself, without involving hospitals. “What is exciting is this is a machine that can be used on a desk,” said Mintz, who has been using the machine in his office to test aspirin resistance in his patients for about six months now.
The test itself, a blood test, is a simple one. A sample of the patient's blood is taken and exposed to certain reagents and within 30 minutes or so one finds out if the blood is thin enough or not. In technical terms, the reagents stimulate platelet aggregation, or thickening of the blood. If the blood does not respond to the stimulation and platelet aggregation does not occur, that is the blood remains thin, the Aspirin is working. “If platelet aggregation does occur, there is a resistance to Aspirin. If this happens there are other medications like Plavix that can be given to the patient,” said Mintz. “Or we could even increase the Aspirin dosage to higher levels for a while and see what effect that has.”
What is important about this test, according to Mintz, is the fact that physicians can now identify patients with aspirin resistance before a stroke or heart attack occurs for the first or even second time. “A lot of what we are doing in cardiology today is about providing medications to improve function and lower risk,” said Mintz, who has been practicing in Glendale for about 10 years.
Stroke being one of the most common causes of death in America, there are three critical groups of people who need to be reached out to, said Mintz. “The first are people who have not yet had a heart attack or stroke but still taking aspirin because they may have a family history. The second are people who have had a heart attack or stroke and need to take aspirin to prevent a second occurrence.”
The third critical group of people are diabetics, said Mintz. “The recommendation is that all diabetics should be on anti-platelet medication, because diabetics die of heart attack and stroke at a much higher rate than others. But many diabetics are not on such medication,” leading to a greater risk of stroke.
If physicians made use of this technology, said Mintz, prevention becomes a lot easier. “We like to treat before you become sick. That's why it's important to get the message out.”
Reach News Editor Rashmi Vaish by e-mail at firstname.lastname@example.org or by phone at 718-229-0300, Ext. 141.