Making sure cardiac patients take an aspirin a day to prevent a second heart attack is part of established treatment for most physicians, and many recommend the same regimen for patients at risk of suffering a first attack. But there has never been scientific evidence to demonstrate that this common, over-the-counter medication really provides any benefit in staving off the underlying condition of atherosclerosis.
Now, mouse-model research by scientists at the University of Pennsylvania School of Medicine has demonstrated that aspirin, ibuprofen and other drugs in the class of pharmaceuticals known as non-specific COX inhibitors may aid substantially in preventing heart disease, slowing the build-up of plaque in blood vessels by more than 50 percent.
"This study suggests that a product of the cyclooxegenase enzyme known as COX-1 -- which is the form targeted by aspirin in the prevention of heart attacks -- may also have a part to play in the gradual hardening of the arteries that precedes acute events like heart attack or stroke," said Garret A. FitzGerald, MD, chairman of Penns Department of Pharmacology. The research will be published March 13 in the Proceedings of the National Academy of Science.
The study also demonstrates that a separate class of drugs that specifically target the COX-2 enzyme -- so-called "super aspirins" such as Celebrex and Vioxx -- do not speed up the development of atherosclerosis, a concern based on some biochemical effects of those drugs. In their work, the Penn scientists scrutinized both known forms of the enzyme cyclooxygenase: COX-1, which is present throughout the body, and COX-2, which is present in some tissues, including the lining of the blood vessels.
COX-1 is the only form of the enzyme in platelets -- blood cells that stick together in the first stages of clotting. Suppression of the platelet COX-1 product, thromboxane, is how aspirin protects against heart attack and stroke.