A new study has found that a group of heart medications called P2Y12 inhibitors may work better than aspirin in preventing heart attacks and strokes in people with coronary artery disease.
Even more importantly, they may do so without causing more serious bleeding problems.
For many years, aspirin has been the go-to medicine for people with heart disease. It helps prevent blood clots, which can cause heart attacks and strokes.
In patients with serious heart conditions, such as acute coronary syndrome, doctors often prescribe both aspirin and a P2Y12 inhibitor for a short time. This is known as dual antiplatelet therapy, or DAPT. After this period, patients usually continue with aspirin alone for the rest of their lives.
Some earlier studies suggested that one of the P2Y12 drugs, called clopidogrel, might slightly lower the chances of having a heart-related event compared to aspirin. This led researchers to wonder: could P2Y12 drugs be a better long-term option than aspirin?
To find out, scientists from the Cardiocentro Ticino Foundation looked at data from over 24,000 patients who already had coronary artery disease.
Half of the patients were given P2Y12 inhibitors (clopidogrel, prasugrel, or ticagrelor), and the other half were given aspirin. The average age of the patients was about 64 years, and about one in five were women. Doctors followed their progress for a little over a year and a half.
The results were promising. Patients taking P2Y12 inhibitors had a 12% lower chance of having a heart attack or stroke compared to those on aspirin. The biggest difference was in heart attacks—people on P2Y12 inhibitors were 23% less likely to have one.
Even better, this stronger protection didn’t come with a higher risk of serious bleeding, which is a common concern with blood-thinning medications. In fact, those on P2Y12 inhibitors had fewer cases of stomach bleeding and bleeding in the brain than those on aspirin.
Professor Marco Valgimigli, the lead researcher, said that these findings could change how doctors treat heart disease in the future. If confirmed by more studies, P2Y12 inhibitors might become the new standard treatment for people with coronary artery disease.
This discovery brings hope to millions of patients around the world. With a treatment that not only works better but is also safer, the future of heart disease prevention may look a lot brighter.
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