An Aspirin a Day

Dateline: 05/07/98

New research suggests that an aspirin a day as a preventive measure against heart attacks has differential effects depending on genetics. Researchers have known for some time that aspirin helps some patients more than others, but this new study traces the effect to a specific factor on platelets.

The study suggests that aspirin may work by targeting an altered gene called PlA2 polymorphism present only in some patients. Scientists estimate that the 30 to 50 percent of the population who may have this gene could benefit from the protective actions of aspirin.

Platelets play a central role in making the blood clot when they bind to a substance called fibrinogen. If this process is disrupted, the likelihood of the blood clotting in the heart is reduced. The authors of the study estimate that the platelets in patients who have the PlA2 polymorphism are from eight to ten times more sensitive to the effects of aspirin than patients who don't have the polymorphism. Thus, aspirin has a significant protective effect on patients with the PlA2 polymorphism.

Polymorphisms can benefit evolution since they don't necessarily change the function of a product by a specific gene. Instead, they exhibit an alternate way of making the protein.

Scientists hope to use this study to develop simple tests that will let people at risk for a heart attack or heart disease know whether they would benefit from taking a daily dose of aspirin. Likewise, by preparing genotypes of their patients, physicians will be able to determine whether or not the patient has the PlA2 polymorphism.

For those patients who don't have the polymorphism, several other medications, particularly antithrombotic medications, would prove more beneficial than aspirin. These alternative medications would provide similar protective effects.

What do you think? Are there other preventive measures that might prove useful? What do you think are the cumulative effects of diet and exercise versus genetic factors? Stop by the Biology Forum and share your thoughts, opinions, and feelings.

For additional information see:

• Aspirin's Preventive Action in Heart Attacks Tied to Genetics
  The original news release concerning the study.