Millions of people across the world taking a daily dose of aspirin to ward off heart attacks are actually increasing their risk. A path breaking new research has found that almost 1 in 4 adults (23%) carry a gene which, when combined with the painkiller, makes them nearly twice as likely to suffer a heart attack.
Aspirin is the gold standard for antiplatelet therapy and a daily low-dose aspirin is widely prescribed for the prevention of cardiovascular disease. Now, the new study suggests that common genetic variation in the gene for catechol-O-methyltransferase (COMT) may modify the cardiovascular benefit of aspirin, and in some people, may confer harm.
The findings are by investigators at Beth Israel Deaconess Medical Center (BIDMC) and Brigham and Women's Hospital (BWH).
"This is one of the few cases where you can identify a single genetic polymorphism which has a significant interaction with aspirin such that it affects whether or not it protects against cardiovascular disease," says Kathryn Hall, an investigator at BIDMC.
COMT is a key enzyme in the metabolism of catecholamines, a group of hormones that include epinephrine, norepinephrine, and dopamine.
"These hormones are implicated in a broad spectrum of disorders, including hypertension," explains Hall, "We were initially interested in finding out if the COMT gene affected people's susceptibility to incident cardiovascular disease such as myocardial infarction or ischemic stroke."
Knowing that aspirin is commonly prescribed for the prevention of incident cardiovascular disease, the investigators also wanted to learn if genetic variation in COMT would influence aspirin's potential benefit. The researchers used data from the Women's Genome Health Study, a cohort of over 23,000 women who were followed for 10 years in a randomized double-blind, placebo-controlled trial of low-dose aspirin or vitamin E for the primary prevention of incident cardiovascular disease.
Their analysis focused on val158met, a common variant in the COMT gene: Individuals who are homozygous for the enzyme's high-activity valine form, the "val/vals," have been shown to have lower levels of catecholamines compared to individuals who are homozygous for the enzyme's low-activity methionine form, the "met/mets,".
"When we examined women in the placebo arm of the trial, we found that the 23% of the women who were 'val/vals' were naturally protected against incident cardiovascular disease," explains Daniel I. Chasman, a genetic epidemiologist at Brigham and Women's Hospital.
Source:Beth Israel Deaconess Medical Center (BIDMC) and Brigham and Women's Hospital (BWH).
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