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Risgenogen reduces the effects of aspirin


Aspirin is affected by certain risk genes

Aspirin is not only used for simple complaints such as headaches, but also as a blood thinner after certain operations. However, some patients do not respond well to the drug. Because researchers have now found that a certain risk gene reduces the anticoagulant effect of aspirin and therefore increases the likelihood of death from a heart attack.

Medicament for numerous complaints

Aspirin is a widely used medication that is used, among other things, for symptoms such as headache, toothache or fever. The blood-thinning agent is also used after certain operations, among other things, to prevent serious diseases such as heart attacks and strokes. But the anticoagulant effect of the drug is reduced by a certain risk gene, as researchers have now found.

Aspirin as a blood thinner

As the German Center for Cardiovascular Research (DZHK) explains in a communication, the coronary vessels are severely narrowed or even completely closed in acute coronary syndrome.

As the therapy of choice, they are reopened using a catheter and a stent is inserted, the experts explain.

However, a major problem after inserting a stent into a blood vessel is clots that clog the stent again.

As a preventative measure, patients are given blood-thinning medication to prevent platelets from clumping and resealing the vessel or stent.

Aspirin and so-called adenosine diphosphate (ADP) receptor antagonists, mostly clopidogrel, are routinely prescribed.

Some patients do not respond well to the medicine

Scientists at the DZHK at the German Heart Center Munich (DHM) and clinic at the Technical University of Munich (TUM) have now found that people who carry a gene variant in GUCY1A3 do not respond as well to aspirin.

Even after the patients took this medicine, their platelets clumped together.

Risk carriers therefore had a higher risk of renewed vascular occlusion or even death from a heart attack after a stent was placed in the coronary arteries.

The results of the researchers were published in the cardiovascular research magazine.

Risk genes for coronary heart disease

First author Dr. Thorsten Kessler from DHM used blood samples from almost 1,800 patients to investigate whether the GUCY1A3 gene variant was present and how her platelets react to aspirin.

The results were then compared with data recorded in three registers regarding the occurrence of a new vascular occlusion or heart attack.

According to the information, in all persons registered in the ISAR-ASPI, PLATO and UCORBIO registers, closed coronary arteries were widened again using a catheter and a stent was inserted.

"GUCY1A3 has long been known as a risk gene for coronary heart disease," says Professor Heribert Schunkert, director of the clinic for cardiovascular diseases in adulthood at the DHM.

"We also know that it plays an important role in the functioning of platelets."

The gene carries the information for a protein that plays a central role in inhibiting platelet aggregation. This in itself inhibits the clumping of the platelets together.

However, in the GUCY1A3 variant examined here, too little of the protein is formed, so that the platelets tend to clump more. What is new is that GUCY1A3 also influences the response to aspirin.

Medicines don't work 100 percent

"Both aspirin and clopidogrel have a certain risk of not being 100% effective," explains Schunkert.

With clopidogrel, this is due to a metabolic pathway that can be modified by a genetic variant so that clopidogrel does not work. However, this variant was not available for the people examined.

According to the experts, the simultaneous occurrence of both gene variants is also extremely unlikely since they are not linked to one another.

Now, further studies are to clarify whether the effects of the risk gene can possibly be offset by prescribing a stronger ADP receptor antagonist, such as ticagrelor or prasugrel, instead of clopidogrel. (ad)

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Video: Who Should And Should Not Take a Daily Low Dose Aspirin. Dr. Oz Answers (January 2022).