Coronary artery calcium score could help guide aspirin therapy

(HealthDay)—For those who have an elevated coronary artery calcium (CAC) score, aspirin therapy may be beneficial for primary prevention of coronary heart disease (CHD), according to research published online May 6 in Circulation: Cardiovascular Quality and Outcomes.

Michael D. Miedema, M.D., M.P.H., of Harvard Medical School in Boston, and colleagues analyzed data for 4,229 participants from the Multi-Ethnic Study of Atherosclerosis to assess the use of CAC scores as a guide to selecting aspirin therapy for primary prevention of CHD.

The researchers found that individuals with a CAC score of 100 or greater had an estimated net benefit for use of aspirin regardless of 10-year CHD Framingham Risk Score (FRS) (estimated five-year number needed to treat, 173 for <10 percent FRS and 92 for ≥10 percent FRS; estimated five-year number to harm of 442 for a major bleed). In contrast, individuals with a CAC score of zero had unfavorable estimations for use of aspirin therapy to prevent CHD (estimated five-year number needed to treat, 2,036 for <10 percent FRS and 808 for ≥10 percent FRS; estimated five-year number to harm of 442 for a major bleed).

"For the primary prevention of coronary heart disease, Multi-Ethnic Study of Atherosclerosis participants with CAC ≥100 had favorable risk/benefit estimations for aspirin use while participants with zero CAC were estimated to receive net harm from aspirin," the authors write.