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Is anti-platelet treatment indicated in primary prevention?


Authors: J. Bultas;  D. Karetová
Published in: Kardiol Rev Int Med 2007, 9(4): 242-246
Category: Editorial

Overview

Thrombosis complications of atherosclerosis are the cause of a pandemic of different cardiovascular diseases in the industrialised world. Since the end of the 1980’s there has been a series of studies monitoring the effect of anti-platelet treatment using acetylsalicylic acid (ASA) as part of primary prevention. Almost one hundred thousand probands have been included in these controlled studies. A composite analysis of the results shows that the treatment is effective in the prevention of acute myocardial infarction, finding a clinically and statistically significant reduction in incidence of around one-third. Undesirable effects accompanying the administration of ASA were bleeding, in particular significant bleeding into the digestive tract. This was recorded in 1–2% of those treated. Treatment with lower dosages of ASA should therefore be indicated in primary prevention only for those probands with a higher risk of coronary incident, i.e.

particularly for older men with an accumulation of at least 2 significant risk factors for atherogenesis.

Keywords:
atherothrombosis – primary prevention – acetylsalicylic acid – myocardial infarction


Sources

1. Gibson P. Salicylic acid for coronary thrombosis? Lancet 1948; 1: 965.

2. Colman RW, Hirsh J, Marder VJ et al. Hemostasis and thrombosis. Philadelphia: Lippincott Williams & Wilkins 2001.

3. Gawaz M. Blood platelets. Stutgart: Georg Thieme Verlag 2001.

4. The Steering Committee of the Physicians’ Health Study Research Group. Findings from the aspirin component of the ongoing Physicians Health Study. N Engl J Med 1988: 318: 262–264.

5. Petro R et al. Randomised trial of prophylactic daily aspirin in British male doctors. BMJ 1988; 296: 313–316.

6. Thrombosis Prevention Trial. Lancet 1988; 351: 233–241.

7. Ridker PM et al. A randomised trial of low dose aspirine in the primary prevention of cardiovascular diseases in woman. N Engl J Med 2005; 352: 1293–1304.

8. Chan AT et al. Long-term aspirin use and mortality in women. Arch Intern Med 2007; 167(6): 562-572.

9. Hansson L et al. Effects of intensive blood pressure lowering and low-dose aspirin in patients with hypertension. HOT Study Group. Lancet 1998; 351: 1855–1862.

10. Bhatt DL at al. A global view of atherothrombosis: baseline characteristics in the Clopidogrel for High Atherothrombotic Risk and Ischemic Stabilization, Management,and Avoidance (CHARISMA) trial. Am Heart J 2005; 150(3): 401.

11. De Schryver EL et al. Cochrane review: dipyridamole for preventing major vascular events in patients with vascular disease. Stroke 2003; 34(8): 2072–2080.

12. Patrono C et al. Expert consensus document on the use of the antiplatelet agents. Eur Heart J 2004; 25(2): 166–181.

13. ETDRS Investigators. Aspirin effects on morbidity and mortality in patients with diabetes mellitus. Early Treatment Diabetic Retinopathy Study Report 14. JAMA 1992; 268: 1292–1300.

14. De Gaetano G et al. Collaborative Group of the Primary Prevention Project. Lancet 2001; 257: 89–95.

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Paediatric cardiology Internal medicine Cardiac surgery Cardiology
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