Prevention of Clinical Thrombosis by Aspirin

A irin has been shown to reduce die risk of a first myocardial inferction in patients with chronic stable angina in two studies, hi the first (a subgroup of the Physicians Health Study referenced above) there was a risk reduction at least as significant as that for the healfoy men emolled in the same trial (42). In the second randomized trial of 2,035 patients, there was a 34% reduction in the incidence of first myocardial induction and sudden cardiac death associated with aspirin (43). 

Based on four randomized, double-blind trials aspirin is clearly effective in unstable angina (45-48). It reduces the risk of MI and cardiac death by 50 to 70% either alone or in concert with the anticoagulant heparin. Aspirin also has a role in reducing the incidence of early closure of saphenous vein bypass grafts of the coronary arteries and following coronary artery angioplasty (49-58). 

Several studies have also demonstrated a role for aspirin, with or without the antiplatelet 

In summary, aspirin is beneficial in a large number of patients at high risk of occlusive cardiovascular disease. The recently reported large meta-analysis of antiplatelet therapy clinical trials suggests risk reduction associated with long term aspirin administration is independent of age, sex, and cardiovascular risk fiictors (44). 

How Lower Doses May Minimize Prostacyclin Syntiiesis Inhibition 

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