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BMJ 2006;333:712-713 (7 October), doi:10.1136/bmj.38992.480544.80
Risk of bleeding is increased but can be minimised
| The first 150 words of the full text of this article appear below. |
The use of aspirin and other antiplatelet agents has sky rocketed in the past decade as the indications have widened to include primary and secondary prevention of myocardial and cerebrovascular ischaemia. In the United States, an estimated 34.8% of men and 26.2% of women over 40 years use aspirin every day or on alternate days.1 Half of these patients are classified as at high risk of cardiovascular disease. With the development of safer antiplatelet agents such as thienopyridines and the publication of major randomised studies, the combination of aspirin and clopidogrel has become a class I recommendation (that is, it is considered to be beneficial, useful, and effective) after percutaneous coronary interventions with stenting in the US and in Europe.2 3 Combined antithrombotic therapy is recommended for up to 12 months "in patients who are not at high risk of bleeding."2 The problem for clinicians is to balance the benefits
Joseph J Y Sung, professor of medicine, chief of gastroenterology
Institute of Digestive Disease, Chinese University of Hong Kong, Hong Kong, PR China
(joesung@cuhk.edu.hk)
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