Aspirin benefits most patients at high risk of vascular events

Antiplatelet therapy with aspirin is beneficial for patients having acute ischaemic events or arterial procedures and for long term maintenance of people with a history of such events or with intermittent claudication, stable angina, or atrial fibrillation. This is the conclusion of an updated collaborative meta-analysis of all randomised trials assessing the effects of antiplatelet therapy on serious vascular events (non-fatal myocardial infarction, non-fatal stroke, or vascular death) by the Antithrombotic Trialists' Collaboration (p 71). The study also showed that for patients requiring prolonged antiplatelet therapy, daily doses of aspirin within the range 75-150 mg are as effective as, but less gastrotoxic than, higher doses. Clopidogrel is an effective alternative for patients who cannot tolerate aspirin. In some clinical circumstances, adding a second antiplatelet drug to aspirin seems to provide additional protection.

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Relevant Article

Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients

Antithrombotic Trialists' Collaboration
BMJ 2002 324: 71-86. [Abstract] [Full Text] [PDF]