Introduction
Heart attack (HA) occurs due to the blockage of coronary arteries supplying oxygen-rich blood into the heart muscles (HM). Blood clots cause blockage in a section of the heart muscle. The blood clots result from rupture and build-up of plaques within the artery, which results in ischemic heart disease and finally a heart attack. The earlier treatment is recommended to avoid cell death of the section affected by blood clots. The recommended treatment for heart disease is aspirin. Aspirin is a non-steroidal anti-inflammatory drug used in the prevention of blood clots.
Mechanism of Action of Aspirin
Aspirin contains a hydroxyl group in its The hydroxyl group of aspirin is esterified into an acetyl group. The acetyl group irreversibly inhibits platelet cyclooxygenase-1 (COX-1) by inhibiting the production of thromboxane-A2 (Cadavid, 2). Additionally, the acetyl group is covalently attached to serine-529 on the active site of the COX-1 enzyme (Cadavid, 2). This inhibits vasoconstriction and coagulation of platelets responsible for the formation of blood clots. Cyclooxygenase is the enzyme required for the synthesis of prostaglandin and thromboxane. The ability of aspirin to covalently bind to serine-529 makes it a unique NSAID.
Platelets are responsible for the formation of blood clots in the body. Platelet aggregation is the clumping of platelet cells resulting in the formation of blood clots.
Patients
DM- diabetes mellitus is associated with increased risks for cardiovascular diseases.
Cardiovascular diseases include myocardial infarction (heart attack), other coronary heart diseases, arrhythmia, congenital heart disease, heart failure, and cardiomyopathy (Peters and Mutharasan 1).
Aspirin helps prevent a second heart attack. Research has demonstrated a positive correlation between using aspirin as a secondary treatment to prevent a second heart attack (Peters and Mutharasan 1).
Research has demonstrated an increased risk of developing heart attacks among patients with a history of alcohol abuse and smoking (Peters and Mutharasan 1).
Some cardiovascular diseases such as heart attacks are hereditary (Peters and Mutharasan 1).
Literature Review
Secondary prevention is the use of measures to limit the progression of an already diagnosed disease. Research studies have demonstrated aspirin is the recommended drug for secondary prevention of heart attack and other cardiovascular diseases (Peters and Mutharasan 1).
Research studies have demonstrated that aspirin is effective in the secondary prevention of cardiovascular diseases (Peters and Mutharasan 1).
The use of aspirin in secondary prevention is well established.
New guidelines recommend the administration of aspirin to patients between the ages of 40 to 70 at high risk of cardiovascular diseases and low bleeding risks. However, it is the administration that discouraged individuals aged 70 years and above and below 40 years (Peters and Mutharasan 1).
A meta-analysis of randomized control trials determined that the primary use of low-dose aspirin reduces the risk of major adverse cardiovascular events and increases the risk of hemorrhages among older diabetic patients (Lin et al., 9). However, its use is recommended for individuals without obvious bleeding risks. Additionally, it is suggested to be administered with proto-pump inhibitors to reduce the risk of bleeding during long-term aspirin use. This study showed inconsistent results with using aspirin as a method of preventing cardiovascular diseases. The administration of aspirin as a primary method for preventing cardiovascular disease is determined by weighing the benefits versus the risk.
Prescription
Most clinical settings administer low-dose aspirin of 80-100mg per day as a primary technique to prevent the reoccurrence of cardiovascular diseases. However, age must be considered before administration
High-risk conditions are bleeding risk disorders. Health care institutions are required to assess each individual before the administration of aspirin (Lin et al., 10). They can be caused by medical conditions or other medications that inhibit aspirin functions (Lin et al., 1). Such medical conditions include gastrointestinal bleeding, peptic ulcer disease, kidney diseases, and hemorrhagic diseases. Medications that increase bleeding risk include other NSAIDs, steroids, and blood thinners.
References
Cadavid, Angela P. “Aspirin: The Mechanism of Action Revisited in the Context of Pregnancy Complications.” Frontiers in Immunology, vol. 8, 2017. Web.
Lin, Ming-Hsun, et al. “Low-Dose Aspirin for the Primary Prevention of Cardiovascular Disease in Diabetic Individuals: A Meta-Analysis of Randomized Control Trials and Trial Sequential Analysis.” Journal of Clinical Medicine, vol. 8, no. 5, 2019, p. 609. Web.
Peters, Andrew T., and R. Kannan Mutharasan. “Aspirin for Prevention of Cardiovascular Disease.” JAMA, vol. 323, no. 7, 2020, p. 676. Web.