Do patients with carotid plaque need to be treated with aspirin?
Earlier, I talked to you about the thickening of the peripheral membrane of the carotid artery, which we call if the > 1.5mm, which we generally call the plaque of the carotid artery. People with these plaques, we talked about stratifying it according to its cardiovascular risk, deciding what level to lower LDL cholesterol to. That is, we are going to use statins, non-statin cholesterol-lowering drugs for treatment.
Today I will discuss with you whether these patients need to be treated with aspirin. Overall, statins are far more aggressive than aspirin in the management of atherosclerosis. We should actively use it for some high-risk patients, unless statins have contraindications, liver function is obviously not good or there is obvious intolerance after eating, if you want to prevent the plaque of your carotid arteries or plaque of the coronary arteries, the progression of atherosclerosis in other places, statins are used as a preferred drug to control the development of this thing, why is it preferred? Because of thistin drugs, everyone may always feel that eating has many side effects, affecting muscles and affecting the kidneys. But in fact, the probability of these side effects in these patients is not very high. Another of these side effects came out that it was reversible and it quickly returned. But aspirin is different, aspirin when used it can completely cause serious fatal bleeding, including cerebral hemorrhage, so these bleeding malignant events are likely to offset its benefits in preventing blood clots.
So generally speaking, we think that if it is simply plaque in the carotid artery and there are no other cardiovascular and cerebrovascular diseases, we do not recommend using it.
Of course, if the carotid artery has severe stenosis, it is not just plaque, it is narrowed by more than 50%, and it belongs to the clear category of cardiovascular and cerebrovascular diseases. This is the time to use aspirin. That is to say, in the secondary prevention of cardiovascular and cerebrovascular diseases, it is generally not recommended to use, and it is clearly recommended to use friends with plaque. Don't take aspirin lightly. If you have any ideas, please contact the Dr. Bian team, we will use the medicine rationally under the guidance of the doctor, so that you can understand your heart better, follow me, and let you know more about cardiovascular health.