Aspirin and Antiplatelet Medications (cont.)

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Aspirin is widely used either alone or in combination with other antiplatelet agents to prevent blood clots from forming in arteries. Aspirin is used specifically in several situations including:

  1. Aspirin often is prescribed in moderate doses (160-325 mg/day) for patients who are having heart attacks to limit the extent of damage to the heart's muscle (by preventing blood clot formation in the blood vessels of the heart), prevent additional heart attacks, and improve survival.

  2. Aspirin often is prescribed to patients undergoing surgery to open or bypass blocked arteries, including percutaneous transluminal coronary angioplasty (PTCA) with or without placement of coronary stents and coronary artery bypass surgery (CABG). Aspirin also is prescribed on a long-term basis to prevent clotting in the stents and/or the bypassed blood vessels.

  3. Aspirin often is prescribed in low doses (75-160 mg/day) on a long-term basis to patients with prior heart attacks or strokes and to patients with TIAs (transient ischemic attacks or mini-strokes) and exertional angina to prevent heart attacks and ischemic strokes.

  4. Aspirin may be used in low dose (75-160mg/day) for prevention of heart attack or stroke in patients with risk factors of these conditions including longstanding diabetes, vascular disease (previous heart attack or stroke, or poor circulation to the legs), or angina.

  5. Aspirin is prescribed in moderate doses (160-325 mg/day) to patients who are having unstable angina to prevent heart attacks and improve survival.

  6. Aspirin is prescribed in moderate doses (160-325 mg/day) to selected patients who are having ischemic strokes to limit damage to the brain, prevent a second stroke, and improve survival.

Treatment of heart attacks

In a large multi-center study (Second International Study of Infarct Survival of the ISIS-2 trial) of patients having acute heart attacks, early treatment (within 24 hours of the onset of symptoms) with aspirin (160 mg/d) was found to reduce deaths from the heart attacks by 23%. The improved survival is believed to be due to aspirin's ability to quickly prevent further blood clots and the expansion of existing clots and thus limit the amount of damage to the heart's muscle.

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