Statin reduces risk for non-obstructive CAD patients but no significant risk reduction for aspirin

Baseline statin use appears to be associated with a significant reduction in major adverse cardiac events — including heart attacks and death — for people with non-obstructive coronary artery disease (CAD), a new study found that was published in Radiology: Cardiothoracic Imaging.[1] 

Aspirin, on the other hand, did not reduce the occurrence of heart attacks, death, or other adverse events for people with non-obstructive CAD, and was not associated with any improvement in clinical outcomes. The study used coronary computed tomography angiography (CCTA) as a first-line test to detect plaque in the vessels. 

“While observational in nature, our data calls into question the value of initiating aspirin therapy following the diagnosis of non-obstructive coronary artery disease on a coronary CT angiography,” said study author Jonathan Leipsic, MD, professor and head of the Department of Radiology at the University of British Columbia in Vancouver, Canada in a statement.

A person diagnosed with coronary artery disease has a buildup of plaque in their veins that narrows the coronary arteries; it is considered “non-obstructive” when that narrowing is less than 50%. The study followed 6,386 participants over five years; 44% of whom had non-obstructive CAD, and 56% of whom had no detectable plaque buildup. 

In participants with no plaque buildup, neither aspirin nor statin improved clinical outcomes.