You can help lower your risk of CAD-related events
Coronary artery disease, or CAD, is a heart condition that may be more common than you think.
More than 370,000 PEOPLE DIE FROM CAD, the most common heart disease in the US, each year.
Up to 8.5 MILLION PEOPLE ARE AFFECTED BY PAD, and about 75% are not even aware of it.
Simply put, CAD is the hardening of arteries, usually caused by the buildup of plaque, around the heart, and there are a number of risk factors that contribute to it. “High blood pressure, high cholesterol, diabetes, smoking, and obesity are the major modifiable risk factors, and the risk factors you can't control include age and family history," says Dr. Sanjum Sethi, a cardiologist at Columbia University Medical Center.
Peripheral artery disease (PAD) occurs when arteries away from the heart, including those that deliver blood to the arms and legs, harden in a similar fashion to CAD, and there is a strong correlation between the two.
“When somebody is at risk for depositing plaques, they deposit plaques in more than one area of the body. So often, if you have CAD, you are at increased risk for having PAD."
Dr. Sanjum Sethi
In people with CAD or PAD, cholesterol, white blood cells, and other substances build up inside damaged artery walls, forming plaque. It's similar to the sludge inside of pipes. As you can imagine, this makes it difficult for blood to travel through these arteries, reducing essential blood flow to the heart. In CAD, this can cause symptoms like chest pain, shortness of breath, and even blood clots. “When I talk to patients, I'm very interested in how much functional activity they are able to do, such as walking around and other daily activities, without getting tired or winded. This is important in terms of understanding whether they have [the] disease and how significant it is," says Dr. Sethi.
Blood clots are a cause for concern for people with CAD or PAD because there is a risk that plaques will rupture inside the artery. Once this happens, your body's blood clotting response is triggered, and a clot forms around the ruptured plaque. For people with CAD, this blood clot can block blood flow to your heart, causing a heart attack, or break off and travel to your brain, causing a stroke. With PAD, a blood clot can form in an artery of the limbs, such as the leg, causing pain or a more serious event that requires amputation. These are serious consequences—some of which can lead to death—all of which can be avoided.
If you've been diagnosed with CAD or PAD or a had a stent procedure or bypass surgery, keep an eye out for symptoms:
- Chest pain
- Shortness of breath
- Heart fluttering, pounding or racing
- Nausea or vomiting
- Leg cramping, numbness, weakness, or coldness
- Sores on toes, or legs
- Change in hair/nail growth on legs or feet
- Change in color or shine on skin of legs
- No pulse or weak pulse in legs or feet
- Erectile dysfunction in men
These risk factors cause damage and inflammation to the artery wall, increasing the chance of a blood clot
Even if you don't experience symptoms, you can still be at risk—especially if you've been diagnosed with CAD, had a heart attack, or received a stent or bypass procedure.
“I use all of the risk factors to understand what a patient's risk is, and based on that, we come up with a treatment plan—whether it be medical, surgical, or invasive—that is tailored to them."
Dr. Sanjum Sethi
There are several procedures that can help restore blood flow in a blocked artery. These include angioplasty, stent implantation, and coronary artery bypass graft surgery (CABG). Angioplasty opens a blocked artery by inflating a tiny balloon inside the blockage. Stent implantation permanently props open a blocked artery with a tiny wire mesh tube that is placed during an angioplasty. CABG reroutes blood around a completely blocked artery using a blood vessel from another part of your body. These procedures may be life-saving, but they do not fix you for good, and you are still at risk even if a heart attack or stent procedure happened a while ago.
Once you have an event like a heart attack or stent procedure, your doctor will likely put you on a treatment plan that includes several medications. These medications may include anticoagulants, or blood thinners, which help prevent blood clots from forming. Another medication is antiplatelets that, like aspirin, keep platelets from sticking together. Many people take aspirin as a blood thinner, but it may not be enough. A large study of almost 40,000 people showed that even though more than half were taking aspirin, the number of heart attacks, strokes, and cardiovascular deaths more than doubled over a two-year period.*
*According to data from the REACH Registry.
XARELTO® 2.5 mg twice daily, when taken with low-dose aspirin,† is proven to help further reduce the risk of blood clots that can cause heart attack, stroke, or cardiovascular death in people with chronic CAD or PAD. In a clinical trial, almost 96% of people with chronic CAD or PAD taking XARELTO® did not have a cardiovascular event.‡
†Low-dose aspirin = 75-mg-100-mg aspirin tablet.
‡Rate of first event (heart attack, stroke, cardiovascular death) was 4.1% for people taking XARELTO® plus aspirin vs. 5.4% for aspirin alone. Patients were followed for an average of 23 months.
What do I need to know about CAD?
CAD (coronary artery disease) is a condition resulting from atherosclerosis, or a hardening of the arteries, which is caused by the buildup of plaque in the arteries that supply blood to the heart—like sludge on the inside of pipes. These plaques can rupture, causing a blood clot to form.
If you've been diagnosed with CAD, had a heart attack, or had a stent or bypass procedure, you may still have an underlying risk for blood clots that can cause a cardiovascular event.
What are the consequences of CAD?
The risk for blood clots in people with CAD is high, and these blood clots can break free and travel through the arteries, which can lead to serious cardiovascular events like stroke and heart attack.
Even if you had a stent procedure, bypass surgery, or a heart attack a while ago, you're taking medication, and you're trying to eat right and stay active, the risk for a cardiovascular event still increases over time.
What is PAD, and how is it related to CAD?
For people with CAD, a blood clot occurs in the arteries that supply blood to the heart, and for people with peripheral artery disease (PAD), a blood clot occurs in the arteries of the limbs—usually the legs.
Both CAD and PAD are the result of hardening of the arteries caused by damage or inflammation of the artery wall due to certain health conditions or risk factors, including diabetes, high blood pressure, high cholesterol, smoking, or a family history of heart disease.
Can I have both CAD and PAD?
It is common for people with CAD to also have PAD. In addition to CAD and PAD sharing similar risk factors, people who have both CAD and PAD have an even higher risk for cardiovascular events than people with CAD or PAD alone, so it's important to ask your doctor about an ankle-brachial index screening test for PAD.
What can I do to lower my risk of developing CAD or PAD?
There are simple things you can do like exercising, maintaining a healthy weight, eating healthy, and managing stress levels. If you are a smoker, quit smoking. And if you have other conditions like diabetes or high cholesterol, manage those as well.
What are the treatments for CAD and PAD?
Some people get a stent placed in their artery or have bypass surgery, while others take blood thinners in addition to a stent.
Some blood thinners, like aspirin, keep platelets from sticking together, while others slow down the blood's clotting process—all to reduce the chance of blood clots that can cause heart attack or stroke.
What else can I do to help lower my risk of cardiovascular events?
CAD and PAD have serious consequences, and both conditions get worse over time. Ask for support from your loved ones to encourage healthy habits.
Most importantly, stay in touch with your healthcare team and take your medications as prescribed by your doctor.
If you are one of the millions who have CAD, you know how important it is to take preventative measures to remain as healthy as possible. Remember, even if you are eating healthy, staying active, and your event occurred a long time ago, you are still at risk. Talk to your doctor to better understand your risk for blood clots that can lead to a cardiovascular event and learn which treatments are best for you.
WHILE ASPIRIN CAN HELP, IT MAY NOT BE ENOUGH. In a large study that included people with CAD or PAD, there was a more than 2X INCREASE IN HEART ATTACKS, STROKE, AND CARDIOVASCULAR DEATH with or without aspirin.* Talk to your doctor about other treatment options to lower your risk for stroke.
*According to data from the REACH Registry.
In a clinical trial, almost 96% of people† with chronic CAD or PAD taking XARELTO® 2.5 mg twice daily in combination with low-dose aspirin§ once daily did not have a heart attack, stroke, or die from a cardiovascular event.
†The rate of the first event was 4.1% for people taking XARELTO® plus aspirin vs 5.4% for aspirin alone. Patients were followed for an average of 23 months.
§Low-dose aspirin = 75-mg-100-mg aspirin tablet.
YOUR DOCTOR IS ALWAYS YOUR BEST RESOURCE. He or she knows your situation best and can help you determine a treatment plan.